Basic Information
Provider Information
NPI: 1881778041
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VOLK
FirstName: RYAN
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: RIVERSIDE ASSOCIATES
Address2: 40 FRONT ST.
City: BINGHAMTON
State: NY
PostalCode: 13905
CountryCode: US
TelephoneNumber: 6077227264
FaxNumber: 6077227869
Practice Location
Address1: RIVERSIDE ASSOCIATES
Address2: 40 FRONT ST.
City: BINGHAMTON
State: NY
PostalCode: 13905
CountryCode: US
TelephoneNumber: 6077227264
FaxNumber: 6077227869
Other Information
ProviderEnumerationDate: 10/24/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XRN5288441NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 
367500000XAANA076143PAN Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


Home