Healthcare Provider Details

I. General information

NPI: 1144910969
Provider Name (Legal Business Name): ANSU THOMAS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANSU BENJAMIN DO

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 ANDREW DR
WEST CHESTER PA
19380-3446
US

IV. Provider business mailing address

1055 ANDREW DR
WEST CHESTER PA
19380-3446
US

V. Phone/Fax

Practice location:
  • Phone: 610-436-4448
  • Fax: 610-431-3707
Mailing address:
  • Phone: 610-436-4448
  • Fax: 610-431-3707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS026045
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: