Provider Demographics
NPI:1134764533
Name:FABRYCKI, RYAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:FABRYCKI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 HOOKSETT RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-2601
Mailing Address - Country:US
Mailing Address - Phone:603-623-1135
Mailing Address - Fax:
Practice Address - Street 1:53 HOOKSETT RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-2601
Practice Address - Country:US
Practice Address - Phone:508-795-9877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-10
Last Update Date:2019-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4214183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PH237469OtherMA BOARD OF PHARMACY
NH4214OtherNH BOARD OF PHARMACY