Kelly Blake Ryder PA-C

NPI 1174718738 - Physician Assistant - 363A00000X

NPI Details
NPI 1174718738
Gender Female
Enumeration Date 09/07/2007
Last Updated 11/17/2015
Entity Type Individual
Active Over 9 years ago
Practice Location
80 SEYMOUR STREET
HARTFORD HOSPITAL SURGERY DEPT.
HARTFORD CT, 06102-5037, US
Phone (860) 972-4670
Fax
Business Location
80 SEYMOUR STREET
HARTFORD HOSPITAL SURGERY DEPT.
HARTFORD CT, 06102-5037, US
Phone (860) 972-4670
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Connecticut
License Number 002185
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According to our database, Ms. Kelly Blake Ryder PA-C NPI is 1174718738, taxonomy code is 363A00000X and license number is 002185, license state is located at Connecticut. Kelly Blake Ryder PA-C physically located at 80 Seymour Street, Hartford CT, 06102-5037. NPI Number Kelly Blake Ryder PA-C has the Individual type.

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1174718738 NPI number is provided on an as is basis without warranty of any kind. 1174718738 is maintained by the National Plan & Provider Enumeration System. The contents of Kelly Blake Ryder PA-C are for informational purposes only.