Provider Demographics
NPI:1831596386
Name:PYSHER, RYAN JAMES (MSW)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:JAMES
Last Name:PYSHER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 HIDDEN CREST LN
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-9397
Mailing Address - Country:US
Mailing Address - Phone:570-447-3363
Mailing Address - Fax:724-852-1338
Practice Address - Street 1:2114 N FRANKLIN DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-5891
Practice Address - Country:US
Practice Address - Phone:724-222-5433
Practice Address - Fax:724-852-1338
Is Sole Proprietor?:No
Enumeration Date:2014-11-28
Last Update Date:2014-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA262101311171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator