MEDICARE: MS. MONICA SHERYL THOMAS L.P.N.

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	164W00000X	Licensed Practical Nurse	187086-1	NY

General Provider Information

NPI Number	:	1477706596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MONICA SHERYL THOMAS L.P.N.

Provider Business Mailing Address
First Line	:	929 JEFFERSON AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11221-4002
Country	:	US
Telephone Number	:	347-393-9367
Fax Number	:

Provider Business Practice Location Address
First Line	:	9715 64TH RD
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-2250
Country	:	US
Telephone Number	:	718-459-5566
Fax Number	:	718-459-6047

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

Provider Enumeration Date	:	11/03/2008
Last Update Date	:	11/03/2008

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