Provider Demographics
NPI:1013237395
Name:SCHRODER, THOMAS JOHN SR (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JOHN
Last Name:SCHRODER
Suffix:SR
Gender:M
Credentials:RPH
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:236 WALDEN CT BLDG 14
Mailing Address - Street 2:
Mailing Address - City:EAST MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11940-1821
Mailing Address - Country:US
Mailing Address - Phone:516-581-9072
Mailing Address - Fax:631-477-1218
Practice Address - Street 1:100 FRONT ST
Practice Address - Street 2:
Practice Address - City:GREENPORT
Practice Address - State:NY
Practice Address - Zip Code:11944-1616
Practice Address - Country:US
Practice Address - Phone:631-477-1111
Practice Address - Fax:631-477-1218
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY34927183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist