Provider Demographics
NPI:1285803650
Name:KOLENO, RYAN RICHARD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:RICHARD
Last Name:KOLENO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3998 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-7824
Mailing Address - Country:US
Mailing Address - Phone:814-574-3706
Mailing Address - Fax:
Practice Address - Street 1:3000 ERICSSON DR STE 100
Practice Address - Street 2:
Practice Address - City:WARRENDALE
Practice Address - State:PA
Practice Address - Zip Code:15086-6501
Practice Address - Country:US
Practice Address - Phone:724-772-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441886183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist