Healthcare Provider Details

I. General information

NPI: 1144505397
Provider Name (Legal Business Name): THOMAS H LATUGA PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2011
Last Update Date: 10/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 10TH ST PHARMACY DEPT
NIAGARA FALLS NY
14302
US

IV. Provider business mailing address

621 10TH ST PHARMACY DEPT
NIAGARA FALLS NY
14302
US

V. Phone/Fax

Practice location:
  • Phone: 716-278-4348
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number054738
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: