Healthcare Provider Details

I. General information

NPI: 1528041282
Provider Name (Legal Business Name): DEBORAH MARIA PINA-THOMAS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/26/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HHC 121ST GENERAL HOSPITAL
APO AP
96205
KR

IV. Provider business mailing address

HHC 18TH MEDCOM BOX 223
APO AP
96205
KR

V. Phone/Fax

Practice location:
  • Phone: 82279175400
  • Fax:
Mailing address:
  • Phone: 822-796-4597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number189653
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: