Provider Demographics
NPI:1073046207
Name:NIPAR, KEVIN RYAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:RYAN
Last Name:NIPAR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:378 W CHESTNUT ST STE 205
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4661
Mailing Address - Country:US
Mailing Address - Phone:724-705-0012
Mailing Address - Fax:724-228-2085
Practice Address - Street 1:378 W CHESTNUT ST STE 205
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4661
Practice Address - Country:US
Practice Address - Phone:724-705-0012
Practice Address - Fax:724-228-2085
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP438726183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist