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General NPI Number Information
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NPI Number | 1689906844
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Entity Type | Individual
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Provider Name | THOMAS HENRY COLLIGAN IV PHARMD, RPH
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Gender | Male
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Dates
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Enumeration Date | 02/12/2010
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Last Update Date | 02/12/2010
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Provider Practice Location Address
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Address Line | 1549 ROUTE 9
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City | HALFMOON
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State | NY
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Zip | 12065
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Country | US
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Telephone | 518-373-5732
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Fax | 518-373-5753
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Provider Business Mailing Address
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Address Line | 17 CHIPMUNK CT
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City | SCHAGHTICOKE
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State | NY
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Zip | 12154-2702
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Country | US
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Telephone | 518-753-4532
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Fax |
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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 | 053480
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License Number State | NY
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