Provider Demographics
NPI:1275865362
Name:CYRAN, GARY (RPH)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:
Last Name:CYRAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1419 E ANDREWS AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-5202
Mailing Address - Country:US
Mailing Address - Phone:252-762-0156
Mailing Address - Fax:252-762-0159
Practice Address - Street 1:1419 E ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-5202
Practice Address - Country:US
Practice Address - Phone:252-762-0156
Practice Address - Fax:252-762-0159
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24859183500000X
NY044918183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist