Provider Demographics
NPI:1265612048
Name:THOMS, CLIFFORD
Entity type:Individual
Prefix:MR
First Name:CLIFFORD
Middle Name:
Last Name:THOMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CANTERBURY RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-2407
Mailing Address - Country:US
Mailing Address - Phone:315-733-4055
Mailing Address - Fax:
Practice Address - Street 1:2308 BLEECKER ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-1746
Practice Address - Country:US
Practice Address - Phone:315-624-0050
Practice Address - Fax:315-624-0051
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25250183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist