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General NPI Number Information
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NPI Number | 1104021070
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Entity Type | Individual
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Provider Name | TANYA SANITA THOMAS M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 845 N MAIN ST STE L1B
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City | PROVIDENCE
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State | RI
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Zip | 02904-5775
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Country | US
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Telephone | 401-863-3476
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Fax | 401-863-3607
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Provider Business Mailing Address
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Address Line | 464 PAVILION AVE
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City | WARWICK
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State | RI
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Zip | 02888-6021
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Country | US
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Telephone | 401-440-1012
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD13358
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | LP01246
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License Number State | RI
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