Provider Demographics
NPI:1689791444
Name:KAUSNER, THOMAS J (RPH)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:KAUSNER
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 1:10 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WELLSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14895-1232
Mailing Address - Country:US
Mailing Address - Phone:585-593-1540
Mailing Address - Fax:585-593-0611
Practice Address - Street 1:10 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14895-1232
Practice Address - Country:US
Practice Address - Phone:585-593-1540
Practice Address - Fax:585-593-0611
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033762183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist