Provider Demographics
NPI:1487467478
Name:ADDARIO, RYAN
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:ADDARIO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 PRINCETON ST UNIT 331
Mailing Address - Street 2:
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-1693
Mailing Address - Country:US
Mailing Address - Phone:781-606-7011
Mailing Address - Fax:
Practice Address - Street 1:101 JACKSON STREET
Practice Address - Street 2:4TH FLOOR
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852
Practice Address - Country:US
Practice Address - Phone:978-459-8656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program