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Individual
DR. SHEA PETER RYAN
Active
Individual
DR. SHEA PETER RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051301280
IL
183500000X
Pharmacist
Primary
069026
NY
183500000X
Pharmacist
PR69231
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051301280
STATE LICENSE
IL
01
—
069026
STATE LICENSE
NY
01
—
PR69231
STATE LICENSE
ME
Enumeration date
08/20/2018
Last updated
05/05/2022
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