Healthcare Provider Details

I. General information

NPI: 1124283346
Provider Name (Legal Business Name): KRISTI L RYZNER PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 09/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 E NEWTON ST PHARMACY DEPARTMENT - ATRIUM H2606
BOSTON MA
02118
US

IV. Provider business mailing address

88 E NEWTON ST PHARMACY DEPARTMENT - ATRIUM H2606
BOSTON MA
02118
US

V. Phone/Fax

Practice location:
  • Phone: 617-414-4216
  • Fax:
Mailing address:
  • Phone: 617-414-4216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number27640
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051292237
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: