Provider Demographics
NPI:1609108562
Name:CSAJKO, THOMAS A (RPH)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:CSAJKO
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 1:158 ROUTE 25A
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-2849
Mailing Address - Country:US
Mailing Address - Phone:631-751-5612
Mailing Address - Fax:631-751-5146
Practice Address - Street 1:158 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-2849
Practice Address - Country:US
Practice Address - Phone:631-751-5612
Practice Address - Fax:631-751-5146
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034349183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist