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General NPI Number Information
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NPI Number | 1316749658
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Entity Type | Individual
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Provider Name | RYAN HAAK
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Gender | Male
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 1225 WESTERN AVE
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City | ALBANY
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State | NY
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Zip | 12203-3317
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Country | US
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Telephone | 518-458-8691
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Fax |
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Provider Business Mailing Address
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Address Line | 25 WILLOW RIDGE LN
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City | LANCASTER
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State | NY
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Zip | 14086-3257
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Country | US
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Telephone | 716-863-2448
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 071724
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License Number State | NY
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