Basic Information
| Provider Information | |||||||||
| NPI: | 1699224014 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FARLEY | ||||||||
| FirstName: | RYAN | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3120 HIGHLAND RD | ||||||||
| Address2: | |||||||||
| City: | HERMITAGE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 161484512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7243422663 | ||||||||
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| Practice Location | |||||||||
| Address1: | 170 N POINTE BLVD | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176014132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172994871 | ||||||||
| FaxNumber: | 7173912494 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2016 | ||||||||
| LastUpdateDate: | 05/15/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.