Provider Demographics
NPI:1538765953
Name:BEYER, THOMAS EDWARD
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:EDWARD
Last Name:BEYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-3671
Mailing Address - Country:US
Mailing Address - Phone:862-397-9073
Mailing Address - Fax:973-827-0949
Practice Address - Street 1:270 ROUTE 23
Practice Address - Street 2:SHOPRITE PLAZA
Practice Address - City:FRANKLIN
Practice Address - State:NJ
Practice Address - Zip Code:07416
Practice Address - Country:US
Practice Address - Phone:862-397-9073
Practice Address - Fax:973-827-0949
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02059200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist