Jimmy Thomas
Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Chestnut RDG, NY
NPI 1679895064 · NPPES record last updated Feb 25, 2010
Key facts
- NPI
- 1679895064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
- License
- 0531561 (NY)
- Practice address
- 557 S Pascack Rd
Chestnut RDG, NY 10977-7113 - Phone
- (914) 310-5780
- NPI assigned
- Feb 25, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0531561 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J and J Pharmacy Corporation | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0531561 | NY | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 0531561 | NY | Yes |
Addresses
Primary practice location
557 S Pascack Rd
Chestnut RDG, NY 10977-7113
Mailing address
557 S Pascack Rd
Chestnut RDG, NY 10977-7113
Phone (914) 310-5780
Other providers in Chestnut RDG, NY
All providers in Chestnut RDG, NY · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.