Provider Demographics
NPI:1932412756
Name:KOCAK, RYAN ALBERT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:ALBERT
Last Name:KOCAK
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 1:4111 N DRINKWATER BLVD
Mailing Address - Street 2:APT B408
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3647
Mailing Address - Country:US
Mailing Address - Phone:412-983-5924
Mailing Address - Fax:
Practice Address - Street 1:1825 E WARNER RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-3403
Practice Address - Country:US
Practice Address - Phone:480-820-9984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS017948183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist