Healthcare Provider Details

I. General information

NPI: 1760136477
Provider Name (Legal Business Name): RYAN BRYNDLE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2022
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 EARHART DR
BUFFALO NY
14221-7079
US

IV. Provider business mailing address

3495 BAILEY AVE
BUFFALO NY
14215-1129
US

V. Phone/Fax

Practice location:
  • Phone: 716-929-1000
  • Fax:
Mailing address:
  • Phone: 716-834-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number066936
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: