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General NPI Number Information
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NPI Number | 1114176658
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Entity Type | Individual
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Provider Name | JOSLIN THOMAS MD
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Gender | Female
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Dates
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Enumeration Date | 09/09/2008
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Last Update Date | 07/11/2021
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Provider Practice Location Address
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Address Line | 25410 75TH AVE APT 1A
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City | GLEN OAKS
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State | NY
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Zip | 11004-1108
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Country | US
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Telephone | 516-348-4573
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Fax |
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Provider Business Mailing Address
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Address Line | 25410 75TH AVE APT 1A
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City | GLEN OAKS
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State | NY
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Zip | 11004-1108
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Country | US
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Telephone | 516-348-4573
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 012174
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 311678
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License Number State | NY
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