Provider Demographics
NPI:1710167549
Name:LOVECCHIO, THOMAS J (BS PHARMACY)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:LOVECCHIO
Suffix:
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 STONEMAN AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:14750-1024
Mailing Address - Country:US
Mailing Address - Phone:716-763-0523
Mailing Address - Fax:
Practice Address - Street 1:12 STONEMAN AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NY
Practice Address - Zip Code:14750-1024
Practice Address - Country:US
Practice Address - Phone:716-763-0523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034180183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist