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General NPI Number Information
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NPI Number | 1447744594
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Entity Type | Individual
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Provider Name | AVINASH THOMAS PA
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Gender | Male
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 2015 W MAIN ST # 350
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City | STAMFORD
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State | CT
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Zip | 06902-4536
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Country | US
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Telephone | 203-863-4588
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Fax |
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Provider Business Mailing Address
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Address Line | 26008 73RD AVE FL 1
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City | GLEN OAKS
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State | NY
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Zip | 11004-1030
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Country | US
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Telephone | 516-770-8331
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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 | 022075
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License Number State | NY
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