Provider Demographics
NPI:1699955948
Name:MCLAUGHLIN, ROBERT THOMAS (RPH)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:THOMAS
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:466 W HAGUE RD
Mailing Address - Street 2:
Mailing Address - City:HAGUE
Mailing Address - State:NY
Mailing Address - Zip Code:12836-2513
Mailing Address - Country:US
Mailing Address - Phone:518-543-6310
Mailing Address - Fax:
Practice Address - Street 1:93 MONTCALM ST
Practice Address - Street 2:
Practice Address - City:TICONDEROGA
Practice Address - State:NY
Practice Address - Zip Code:12883-1343
Practice Address - Country:US
Practice Address - Phone:518-585-6787
Practice Address - Fax:518-585-9860
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040907183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01390394Medicaid