Healthcare Provider Details

I. General information

NPI: 1497685333
Provider Name (Legal Business Name): NEETHA THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 HULL AVE
NEW HYDE PARK NY
11040-3134
US

IV. Provider business mailing address

22 HULL AVE
NEW HYDE PARK NY
11040-3134
US

V. Phone/Fax

Practice location:
  • Phone: 718-206-6000
  • Fax:
Mailing address:
  • Phone: 718-206-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberF350610
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: