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General NPI Number Information
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NPI Number | 1821760992
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Entity Type | Individual
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Provider Name | RYAN MATTHEW WHALEN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/28/2021
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 202 BROAD ST
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City | GLENS FALLS
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State | NY
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Zip | 12801-4146
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Country | US
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Telephone | 802-849-9372
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Fax |
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Provider Business Mailing Address
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Address Line | 915 ST DAVIDS LN
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City | NISKAYUNA
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State | NY
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Zip | 12309-5506
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Country | US
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Telephone | 802-236-5574
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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 | 033.0134584
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License Number State | VT
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