Provider Demographics
NPI:1336397264
Name:TWOMEY, THOMAS EDWARD (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:EDWARD
Last Name:TWOMEY
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 BRENTWOOD RD
Mailing Address - Street 2:BUILDING ONE
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-5543
Mailing Address - Country:US
Mailing Address - Phone:631-299-3029
Mailing Address - Fax:631-299-3049
Practice Address - Street 1:1725 BRENTWOOD RD
Practice Address - Street 2:BUILDING ONE
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-5543
Practice Address - Country:US
Practice Address - Phone:631-299-3029
Practice Address - Fax:631-299-3049
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026406183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist