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General NPI Number Information
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NPI Number | 1417976531
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Entity Type | Individual
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Provider Name | TERESA ELIZABETH THOMAS M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 04/19/2018
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Provider Practice Location Address
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Address Line | 101 PROSPECT ST STE 212
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5003
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Country | US
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Telephone | 732-886-9400
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Fax | 732-905-7719
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Provider Business Mailing Address
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Address Line | 101 PROSPECT ST
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5020
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Country | US
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Telephone | 732-886-9400
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Fax | 732-905-7719
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MA05660400
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License Number State | NJ
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