Provider Demographics
NPI:1467657254
Name:H RYDER INC
Entity Type:Organization
Organization Name:H RYDER INC
Other - Org Name:THE SPECTACLE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:RYDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-561-7170
Mailing Address - Street 1:224 TOM MILLER RD
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-6427
Mailing Address - Country:US
Mailing Address - Phone:518-561-7170
Mailing Address - Fax:518-561-6129
Practice Address - Street 1:224 TOM MILLER RD
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-6427
Practice Address - Country:US
Practice Address - Phone:518-561-7170
Practice Address - Fax:518-561-6129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01440642Medicaid
NY01649265Medicaid
NY54448BMedicare ID - Type Unspecified
NY01649265Medicaid