Provider Demographics
NPI:1134246242
Name:THOMAN, PATRICIA ELLYN (RPH)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ELLYN
Last Name:THOMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:10953 STATE RD
Mailing Address - Street 2:POB 96
Mailing Address - City:GLENWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:14069-0096
Mailing Address - Country:US
Mailing Address - Phone:716-592-7013
Mailing Address - Fax:715-592-7013
Practice Address - Street 1:10953 STATE RD
Practice Address - Street 2:POB 96
Practice Address - City:GLENWOOD
Practice Address - State:NY
Practice Address - Zip Code:14069-0096
Practice Address - Country:US
Practice Address - Phone:716-592-7013
Practice Address - Fax:715-592-7013
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260451835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric