Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 25MA09518100 | NJ |
NPI | 1215258470 |
---|---|
Provider Name | Dr. Ryan J Lingor |
First Address | Cedar Knolls, NJ 07927-2111 |
Second Address | New York, NY 10021-4099 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2010 |
Last Update Date | 01/02/2021 |