Provider Demographics
NPI:1275852030
Name:COMANZO, RALPH N (BS PHARM RPH)
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:N
Last Name:COMANZO
Suffix:
Gender:M
Credentials:BS PHARM RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2358 ST JOSEPH DR
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-2215
Mailing Address - Country:US
Mailing Address - Phone:518-372-9171
Mailing Address - Fax:
Practice Address - Street 1:59 HETCHLTOWN RD
Practice Address - Street 2:
Practice Address - City:SCOTIA
Practice Address - State:NY
Practice Address - Zip Code:12309
Practice Address - Country:US
Practice Address - Phone:518-384-3635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224422-11835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric