Provider Demographics
NPI:1750575668
Name:RYAN, ALLISON ROBYN (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:ROBYN
Last Name:RYAN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9296 BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:SAUQUOIT
Mailing Address - State:NY
Mailing Address - Zip Code:13456-2004
Mailing Address - Country:US
Mailing Address - Phone:315-737-2278
Mailing Address - Fax:
Practice Address - Street 1:2150 BLEECKER ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-1738
Practice Address - Country:US
Practice Address - Phone:315-798-4930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013494-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist