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NPI Code Detail

MEDICARE: MR. JOHN THOMAS

MEDICARE: MR. JOHN THOMAS
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
1225100000XPhysical Therapist039429NY

General Provider Information

NPI Number : 1750506853
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN THOMAS
Provider Business Mailing Address
First Line : 657 COLLFIELD AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-4258
Country : US
Telephone Number : 718-619-0170
Fax Number : 718-698-2475
Provider Business Practice Location Address
First Line : 25 FANNING ST
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-5307
Country : US
Telephone Number : 718-289-7004
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2007
Last Update Date : 07/23/2024

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Directions to “ MR. JOHN THOMAS ” Practice Location

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