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NPI Code Detail

MEDICARE: MR. THOMAS M DEALY RPH

MEDICARE:  MR. THOMAS M DEALY  RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist045820-1NY

General Provider Information

NPI Number : 1679743595
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. THOMAS M DEALY RPH
Provider Business Mailing Address
First Line : PO BOX 122
Second Line :
City : GARDEN CITY
State : NY
Zip : 11530-0122
Country : US
Telephone Number : 516-993-9246
Fax Number :
Provider Business Practice Location Address
First Line : 492 ATLANTIC AVE
Second Line :
City : EAST ROCKAWAY
State : NY
Zip : 11518-1517
Country : US
Telephone Number : 516-599-2233
Fax Number : 516-596-3285
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2008
Last Update Date : 03/06/2008

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Directions to “ MR. THOMAS M DEALY RPH” Practice Location

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