Provider Demographics
NPI:1427373976
Name:HURYN, LARYSSA U (RPH)
Entity Type:Individual
Prefix:
First Name:LARYSSA
Middle Name:U
Last Name:HURYN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1639 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-4646
Mailing Address - Country:US
Mailing Address - Phone:212-879-1260
Mailing Address - Fax:212-737-4656
Practice Address - Street 1:1639 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-4646
Practice Address - Country:US
Practice Address - Phone:212-879-1260
Practice Address - Fax:212-737-4656
Is Sole Proprietor?:No
Enumeration Date:2010-03-28
Last Update Date:2010-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30839183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist