| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KATIE RYDER | 1336890821 | 2022-01-16 |
Katie Ryder is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1336890821. Registration indicates Katie Ryder is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| Entity Type | Individual |
| Provider Name | Katie Ryder PA-C |
| Practice Office Address | 75 FRANCIS ST BOSTON, MA US |
| Practice Office Telephone | 6177325500 |
| Mailing Address | 495 WESTERN AVE BRIGHTON, MA 021351007 US |
| Business Telephone | 6177830500 |
| Business Fax | 6175621398 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 495 Western Ave | Brighton, MA 021351007 | 6177830500 / 6175621398 |
| Code | Practice | License No State |
|---|---|---|
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers |