Provider Demographics
NPI:1750604914
Name:PITTS, RYAN MICHAEL (RPH)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:MICHAEL
Last Name:PITTS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 CAMBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-6145
Mailing Address - Country:US
Mailing Address - Phone:518-371-4851
Mailing Address - Fax:
Practice Address - Street 1:22 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOOSICK FALLS
Practice Address - State:NY
Practice Address - Zip Code:12090-2002
Practice Address - Country:US
Practice Address - Phone:518-686-5831
Practice Address - Fax:518-686-4185
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15969183500000X
NY050243183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist