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General NPI Number Information
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NPI Number | 1245422740
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Entity Type | Individual
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Provider Name | ANITA THOMAS DNP, ANP-BC, CWS
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Gender | Female
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Dates
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Enumeration Date | 08/17/2007
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Last Update Date | 02/22/2022
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Provider Practice Location Address
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Address Line | 647 MAIN AVE STE 207
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City | PASSAIC
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State | NJ
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Zip | 07055-4962
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Country | US
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Telephone | 973-735-1231
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Fax | 973-735-1232
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Provider Business Mailing Address
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Address Line | 172 HEBBERD AVE
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City | PARAMUS
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State | NJ
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Zip | 07652-4452
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Country | US
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Telephone | 201-572-8136
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ00133100
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License Number State | NJ
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