Michael T Ryan, RPH
Individual provider Active NPI Pharmacist · Dunellen, NJ
NPI 1992963581 · NPPES record last updated May 30, 2008
Key facts
- NPI
- 1992963581
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 28RI01518600 (NJ)
- Practice address
- 374 North Ave
Dunellen, NJ 08812-1221 - Phone
- (732) 968-0003
- NPI assigned
- May 30, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI01518600 | NJ | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI01518600 | NJ | Yes |
Addresses
Primary practice location
374 North Ave
Dunellen, NJ 08812-1221
Mailing address
374 North Ave
Dunellen, NJ 08812-1221
Phone (732) 968-0003
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4424506 | Medicaid | NJ |
Other providers in Dunellen, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.