Healthcare Provider Details

I. General information

NPI: 1942514641
Provider Name (Legal Business Name): RYAN MICHAEL TANNIAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2010
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 NEWMARKET ST
PORTSMOUTH NH
03803-1000
US

IV. Provider business mailing address

302 NEWMARKET ST
PORTSMOUTH NH
03803-1000
US

V. Phone/Fax

Practice location:
  • Phone: 603-430-2340
  • Fax:
Mailing address:
  • Phone: 603-430-2340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPR45899
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3694
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH235763
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: