Provider Demographics
NPI:1184134793
Name:PASAOA, RYAN TERRENCE AQUINO (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:RYAN TERRENCE
Middle Name:AQUINO
Last Name:PASAOA
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 FRANKLIN AVE
Mailing Address - Street 2:PHARMACY DEPT
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-8502
Mailing Address - Country:US
Mailing Address - Phone:516-256-6000
Mailing Address - Fax:
Practice Address - Street 1:900 FRANKLIN AVE
Practice Address - Street 2:PHARMACY DEPT
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-8502
Practice Address - Country:US
Practice Address - Phone:516-256-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-10
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063341183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist