Provider Demographics
NPI:1730329988
Name:RYABOY, ANNA (PT)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:
Last Name:RYABOY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 MCCLEAN AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-4460
Mailing Address - Country:US
Mailing Address - Phone:646-662-6555
Mailing Address - Fax:718-556-9432
Practice Address - Street 1:334 MCCLEAN AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-4460
Practice Address - Country:US
Practice Address - Phone:646-662-6555
Practice Address - Fax:718-556-9432
Is Sole Proprietor?:No
Enumeration Date:2009-03-01
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018152-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics