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General NPI Number Information
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NPI Number | 1407813074
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Entity Type | Individual
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Provider Name | JAMES THOMAS DO
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Gender | Male
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 07/18/2014
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Provider Practice Location Address
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Address Line | 24 ASHBURN RD
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City | WAYNE
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State | NJ
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Zip | 07470-2642
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Country | US
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Telephone | 973-956-0615
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Fax | 973-341-6114
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Provider Business Mailing Address
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Address Line | 24 ASHBURN RD WAYNE
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City | WAYNE
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State | NJ
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Zip | 07470-2642
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Country | US
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Telephone | 973-956-0615
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Fax | 973-341-6114
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 196092
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License Number State | NY
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