MEDICARE: JOHN THOMAS PC

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	207R00000X	Internal Medicine Physician	122095	NY

General Provider Information

NPI Number	:	1154310498
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN THOMAS PC

Provider Business Mailing Address
First Line	:	832 PELHAM PKWY S
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-1139
Country	:	US
Telephone Number	:	718-597-0200
Fax Number	:	718-597-0201

Provider Business Practice Location Address
First Line	:	38 MCKINLEY PL
Second Line	:
City	:	ARDSLEY
State	:	NY
Zip	:	10502-2322
Country	:	US
Telephone Number	:	914-693-6547
Fax Number	:	914-693-6547

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. JOHN THOMAS
Credential	:	MD
Telephone Number	:	914-693-6547

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	03/04/2016

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