National Provider Identifier
Ryan Reno Dirienzo, PA-C
Ryan Reno Dirienzo, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Ithaca, NY and a listed phone number of (607) 272-7000.
Profile Overview
- NPI
- 1205464344
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- April 01, 2020
- Last Updated
- November 12, 2020
Practice Location
- 16 Brentwood Dr
- Ithaca, NY 14850-1863
Phone: (607) 272-7000
Mailing Address
- 1 Eldorado Dr Apt D
- Trumansburg, NY 14886-9333
Specialties
- Physician Assistant (363A00000X)
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1205464344
- Entity Type
- Individual
- Last Name
- Dirienzo
- First Name
- Ryan
- Middle Name
- Reno
- Credential
- PA-C
- Mailing Street Address
- 1 Eldorado Dr Apt D
- Mailing City
- Trumansburg
- Mailing State
- NY
- Mailing ZIP Code
- 14886-9333
- Mailing Country
- US
- Mailing Phone
- (860) 543-5528
- Practice Street Address
- 16 Brentwood Dr
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-1863
- Practice Country
- US
- Practice Phone
- (607) 272-7000
- Enumeration Date
- April 01, 2020
- Last Updated
- November 12, 2020
- Sex
- Male
- Sole Proprietor
- Yes
- Taxonomy Group 2
- 193400000X Single Specialty Group
- Certification Date
- November 12, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X), Student in an Organized Health Care Education/Training Program (390200000X)