Healthcare Provider Details

I. General information

NPI: 1255800991
Provider Name (Legal Business Name): FIONA MARIE THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2018
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3938 DURYEA AVE
BRONX NY
10466-2441
US

IV. Provider business mailing address

661 NEREID AVE FL 1
BRONX NY
10470-1519
US

V. Phone/Fax

Practice location:
  • Phone: 347-638-7129
  • Fax:
Mailing address:
  • Phone: 347-639-9672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number964241-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: