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General NPI Number Information
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NPI Number | 1043331085
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Entity Type | Organization
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Legal Business Name | SEYMOUR W THOMAS
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 424 CLIFTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07011-2645
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Country | US
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Telephone | 973-340-3700
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Fax | 973-340-4668
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Provider Business Mailing Address
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Address Line | PO BOX 4195
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City | CLIFTON
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State | NJ
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Zip | 07012-8195
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Country | US
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Telephone | 973-458-0422
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Fax | 973-458-0661
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | ANNAMARIA CONKLIN
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Credential |
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Telephone | 973-458-0422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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