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General NPI Number Information
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NPI Number | 1285922492
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Entity Type | Individual
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Provider Name | KRYSTAL M. THOMAS PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/21/2011
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Last Update Date | 02/28/2020
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Provider Practice Location Address
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Address Line | 4 LIFE MARK DR
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City | SELLERSVILLE
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State | PA
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Zip | 18960-1577
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Country | US
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Telephone | 215-453-4026
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Fax | 215-453-4719
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Provider Business Mailing Address
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Address Line | PO BOX 829641
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City | PHILADELPHIA
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State | PA
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Zip | 19182-0001
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Country | US
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Telephone | 267-370-5296
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Fax | 215-230-3725
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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 | MA054981
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License Number State | PA
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