MEDICARE: THOMAS CONNORS

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	208000000X	Pediatrics Physician	256244	NY

General Provider Information

NPI Number	:	1588822167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS CONNORS

Provider Business Mailing Address
First Line	:	20 W 85TH ST APT A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-4553
Country	:	US
Telephone Number	:	908-461-4252
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 W 85TH ST APT A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-4553
Country	:	US
Telephone Number	:	908-461-4252
Fax Number	:

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

Provider Enumeration Date	:	05/29/2008
Last Update Date	:	01/02/2015

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Directions to “ THOMAS CONNORS ” Practice Location

Language	Start Address	Practice Location

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