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General NPI Number Information
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NPI Number | 1437331865
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Entity Type | Individual
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Provider Name | LIZA THOMAS RPH
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Gender | Female
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Dates
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Enumeration Date | 11/27/2007
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 4002 BROADWAY
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City | ASTORIA
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State | NY
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Zip | 11103-4031
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Country | US
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Telephone | 718-278-2100
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Fax | 718-278-0116
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Provider Business Mailing Address
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Address Line | 137 BUFFALO AVE
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City | MEDFORD
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State | NY
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Zip | 11763-3710
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Country | US
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Telephone | 516-770-4194
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Fax | 631-730-2873
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 037215
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License Number State | NY
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