Provider Demographics
NPI:1114441110
Name:ALPINO, RYAN MICHAEL (OD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:MICHAEL
Last Name:ALPINO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 BIRDIE CT
Mailing Address - Street 2:
Mailing Address - City:MAIDSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26541-8189
Mailing Address - Country:US
Mailing Address - Phone:412-580-7466
Mailing Address - Fax:
Practice Address - Street 1:4917 1/2 DIXIE HWY
Practice Address - Street 2:SUITE H
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216
Practice Address - Country:US
Practice Address - Phone:502-447-1799
Practice Address - Fax:502-447-3083
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2033-IOD1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist