MEDICARE: THOMAS JOHN SCHYMANSKI PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0110001156	VA
2	363AM0700X	Medical Physician Assistant

General Provider Information

NPI Number	:	1003807405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS JOHN SCHYMANSKI PA-C

Provider Business Mailing Address
First Line	:	PO BOX 71230
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19176-6230
Country	:	US
Telephone Number	:	703-383-6469
Fax Number	:

Provider Business Practice Location Address
First Line	:	13350 FRANKLIN FARM ROAD
Second Line	:	STE 220
City	:	HERNDON
State	:	VA
Zip	:	20171-4095
Country	:	US
Telephone Number	:	703-810-5204
Fax Number	:	703-810-5411

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	02/28/2014

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