Provider Demographics
NPI:1437250032
Name:CAHILL, RYAN M (DO)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:M
Last Name:CAHILL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 NORTHERN BLVD STE 328
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5329
Mailing Address - Country:US
Mailing Address - Phone:516-233-2484
Mailing Address - Fax:516-304-5850
Practice Address - Street 1:1400 DEER PARK AVE STE 2
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-1618
Practice Address - Country:US
Practice Address - Phone:631-669-6666
Practice Address - Fax:631-669-6693
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222902207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02316278Medicaid
NY222902OtherLICENSE
NY77V071OtherEMPIRE NUMBER
NYP2635243NOtherOXFORD
NY010796177OtherTAX ID
NY2464948OtherCIGNA
NY080194302OtherR.R. MEDICARE
NY5997128OtherGHI
NY02316278Medicaid
NY58359POtherHIP
NY222902OtherLICENSE
NY5027DGW371Medicare PIN
NY010796177OtherTAX ID