Provider Demographics
NPI:1275873796
Name:ELL, THOMAS S (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:S
Last Name:ELL
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 1:349 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3342
Mailing Address - Country:US
Mailing Address - Phone:631-427-2919
Mailing Address - Fax:631-427-2909
Practice Address - Street 1:349 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3342
Practice Address - Country:US
Practice Address - Phone:631-427-2919
Practice Address - Fax:631-427-2909
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055735183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist