Provider Demographics
NPI:1386793487
Name:THOMAS, MICHAEL GERARD (PHARMD, MS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GERARD
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PHARMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16631 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-2056
Mailing Address - Country:US
Mailing Address - Phone:718-767-5185
Mailing Address - Fax:
Practice Address - Street 1:234 EAST 149TH STREET
Practice Address - Street 2:LINCOLN MEDICAL AND MENTAL HEALTH CENTER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451
Practice Address - Country:US
Practice Address - Phone:718-579-6267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY369961835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy