Provider Demographics
NPI:1932624772
Name:THOMAS, RYAN STEPHEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:STEPHEN
Last Name:THOMAS
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 1:158 GOLDEN OAKS WAY
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-2490
Mailing Address - Country:US
Mailing Address - Phone:585-738-4791
Mailing Address - Fax:
Practice Address - Street 1:158 GOLDEN OAKS WAY
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-2490
Practice Address - Country:US
Practice Address - Phone:585-738-4791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-12
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063168183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist