Provider Demographics
NPI:1124217773
Name:THOMAS, JOSEPH (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:THOMAS
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 1:1220 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-5624
Mailing Address - Country:US
Mailing Address - Phone:516-794-7876
Mailing Address - Fax:516-794-7852
Practice Address - Street 1:1220 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-5624
Practice Address - Country:US
Practice Address - Phone:516-794-7876
Practice Address - Fax:516-794-7852
Is Sole Proprietor?:No
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046038-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist