Healthcare Provider Details

I. General information

NPI: 1316915374
Provider Name (Legal Business Name): THOMAS ELIAS POBRE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 04/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 HEMPSTEAD TPKE
EAST MEADOW NY
11554-1859
US

IV. Provider business mailing address

2201 HEMPSTEAD TPKE
EAST MEADOW NY
11554-1859
US

V. Phone/Fax

Practice location:
  • Phone: 516-572-6525
  • Fax: 516-572-3170
Mailing address:
  • Phone: 516-572-6525
  • Fax: 516-572-3170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number204356
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: