Individual ProviderWalter W. RyderPharmacistPharmacy Service ProvidersPractice Address593 Fort Washington Ave, New York, NY 10033-1908(212) 568-5511PECOS EnrollmentBased on the most recent information from CMS, provider Walter W. Ryder does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 11 days ago.Profile DetailsProvider ID1598042368Provider TypeIndividualFull NameRyder, Walter W.CredentialPHARMACISTGenderMaleSole ProprietorYesEnumeration Date11/8/2011Last Updated11/8/2011Contact InformationPractice LocationPractice Address593 Fort Washington Ave, New York, NY 10033-1908Phone(212) 568-5511Fax(212) 795-8146Mailing LocationMailing Address593 Fort Washington Ave, New York, NY 10033-1908Phone(212) 568-5511Fax(212) 795-8146Provider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicense022914New YorkProvider IdentifiersIDDescriptionIssuerID01636548DescriptionMedicaidIssuerUnlistedNew York