MEDICARE: MR. THOMAS LEMME 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	002512	NY
2	363AM0700X	Medical Physician Assistant	MA051588	PA

General Provider Information

NPI Number	:	1922232321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS LEMME PA-C

Provider Business Mailing Address
First Line	:	337 YALE RD
Second Line	:
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-5223
Country	:	US
Telephone Number	:	516-857-6624
Fax Number	:	516-673-0611

Provider Business Practice Location Address
First Line	:	337 YALE RD
Second Line	:
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-5223
Country	:	US
Telephone Number	:	516-857-6624
Fax Number	:	516-673-0611

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

Provider Enumeration Date	:	05/13/2009
Last Update Date	:	04/19/2011

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