MEDICARE: REBECCA MARY THOMAS 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	MA057716	PA

General Provider Information

NPI Number	:	1427432061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA MARY THOMAS PA-C

Provider Business Mailing Address
First Line	:	300 TECHNOLOGY DR
Second Line	:
City	:	COAL CENTER
State	:	PA
Zip	:	15423-1065
Country	:	US
Telephone Number	:	724-938-7466
Fax Number	:	724-938-7470

Provider Business Practice Location Address
First Line	:	300 TECHNOLOGY DR
Second Line	:
City	:	COAL CENTER
State	:	PA
Zip	:	15423-1065
Country	:	US
Telephone Number	:	724-938-7466
Fax Number	:	724-938-7470

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

Provider Enumeration Date	:	07/14/2015
Last Update Date	:	07/15/2022

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