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General NPI Number Information
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NPI Number | 1134246242
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Entity Type | Individual
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Provider Name | PATRICIA ELLYN THOMAN RPH
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Gender | Female
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10953 STATE RD POB 96
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City | GLENWOOD
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State | NY
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Zip | 14069-0096
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Country | US
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Telephone | 716-592-7013
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Fax | 715-592-7013
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Provider Business Mailing Address
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Address Line | 10953 STATE RD POB 96
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City | GLENWOOD
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State | NY
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Zip | 14069-0096
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Country | US
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Telephone | 716-592-7013
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Fax | 715-592-7013
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835G0303X
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Taxonomy Name | Geriatric Pharmacist
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License Number | 26045
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License Number State | NY
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