Healthcare Provider Details

I. General information

NPI: 1154617322
Provider Name (Legal Business Name): SHEREMA THOMSON LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2011
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 BI COUNTY BLVD
FARMINGDALE NY
11735-3943
US

IV. Provider business mailing address

110 BI COUNTY BLVD
FARMINGDALE NY
11735-3943
US

V. Phone/Fax

Practice location:
  • Phone: 631-358-9502
  • Fax:
Mailing address:
  • Phone: 631-358-9502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number303515
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: