Provider Demographics
NPI:1841339280
Name:RYDER, ALEJANDRA CAROLINA (RPH)
Entity type:Individual
Prefix:MRS
First Name:ALEJANDRA
Middle Name:CAROLINA
Last Name:RYDER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:ALEJANDRA
Other - Middle Name:CAROLINA
Other - Last Name:COTTELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:9 HORSESHOE RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-3334
Mailing Address - Country:US
Mailing Address - Phone:908-382-6456
Mailing Address - Fax:
Practice Address - Street 1:9 HORSESHOE RD
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE STATION
Practice Address - State:NJ
Practice Address - Zip Code:08889-3334
Practice Address - Country:US
Practice Address - Phone:908-382-6456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02411600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI02411600OtherPHARMACY LICENSE