Provider Demographics
NPI:1811190432
Name:PIPER, BRYAN MATTHEW (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:MATTHEW
Last Name:PIPER
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 1:1 FAIRBOURNE PARK
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-1292
Mailing Address - Country:US
Mailing Address - Phone:585-749-9421
Mailing Address - Fax:
Practice Address - Street 1:430 SPENCERPORT RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14606-5219
Practice Address - Country:US
Practice Address - Phone:585-247-2710
Practice Address - Fax:585-247-1755
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050377183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist