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General NPI Number Information
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NPI Number | 1275806796
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Entity Type | Individual
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Provider Name | RYAN L LIVINGSTON CPHT
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Gender | Male
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Dates
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Enumeration Date | 02/14/2012
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Last Update Date | 02/14/2012
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Provider Practice Location Address
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Address Line | 54 ELLIOTT ST
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City | BEVERLY
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State | MA
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Zip | 01915-3359
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Country | US
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Telephone | 978-921-0506
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Fax | 978-921-0129
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Provider Business Mailing Address
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Address Line | 384 SUMMER ST CARRIAGE HOUSE
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City | MANCHESTER
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State | MA
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Zip | 01944-1580
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Country | US
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Telephone | 305-905-8101
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | TCH86537
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | PT8780
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License Number State | MA
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