Provider Demographics
NPI:1821091372
Name:TOMASSETTI DRUG CORP
Entity Type:Organization
Organization Name:TOMASSETTI DRUG CORP
Other - Org Name:NEERGAARD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:SUTHERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-857-1600
Mailing Address - Street 1:120 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-1372
Mailing Address - Country:US
Mailing Address - Phone:718-857-1600
Mailing Address - Fax:718-398-6559
Practice Address - Street 1:120 7TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-1372
Practice Address - Country:US
Practice Address - Phone:718-857-1600
Practice Address - Fax:718-398-6559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019894332B00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01091294Medicaid
NY01091294Medicaid