Healthcare Provider Details

I. General information

NPI: 1538010160
Provider Name (Legal Business Name): ARUN THOMAS PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 BARD AVE
STATEN ISLAND NY
10310-1699
US

IV. Provider business mailing address

1309 VINCENZO DR
TOMS RIVER NJ
08753-2769
US

V. Phone/Fax

Practice location:
  • Phone: 718-818-1234
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number407567
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: