Provider Demographics
NPI:1982072906
Name:DECARO, RYAN CHRISTOPHER (R PH PHARMD MBA)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:CHRISTOPHER
Last Name:DECARO
Suffix:
Gender:M
Credentials:R PH PHARMD MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-3632
Mailing Address - Country:US
Mailing Address - Phone:585-241-9000
Mailing Address - Fax:585-454-2017
Practice Address - Street 1:259 MONROE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-3632
Practice Address - Country:US
Practice Address - Phone:585-241-9000
Practice Address - Fax:585-454-2017
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061132183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist