Individual
ANUP MALIACKEL THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
296 LATHROP AVE, STATEN ISLAND, NY 10314-2047
(718) 473-2871
Mailing address
296 LATHROP AVE, STATEN ISLAND, NY 10314-2047
(718) 473-2871
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1058933
NY
183500000X
Pharmacist
28RI03411700
NJ
Other
Enumeration date
08/30/2016
Last updated
08/30/2016
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