Healthcare Provider Details

I. General information

NPI: 1609660406
Provider Name (Legal Business Name): BLESSY THOMAS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6608 CASTOR AVE
PHILADELPHIA PA
19149-2120
US

IV. Provider business mailing address

6608 CASTOR AVE
PHILADELPHIA PA
19149-2120
US

V. Phone/Fax

Practice location:
  • Phone: 215-342-7710
  • Fax:
Mailing address:
  • Phone: 215-342-7710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP31977
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: