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General NPI Number Information
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NPI Number | 1790159283
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Entity Type | Organization
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Legal Business Name | THOMAS PEDIATRICS LLC
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Dates
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Enumeration Date | 11/20/2015
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Last Update Date | 01/15/2016
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Provider Practice Location Address
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Address Line | 654 NEWMAN SPRINGS ROAD SUITE E
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City | LINCROFT
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State | NJ
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Zip | 07738
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Country | US
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Telephone | 732-677-2092
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Fax | 732-383-7952
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Provider Business Mailing Address
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Address Line | 654 NEWMAN SPRINGS ROAD SUITE E
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City | LINCROFT
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State | NJ
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Zip | 07738
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Country | US
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Telephone | 732-677-2092
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Fax | 732-383-7952
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. USHA THOMAS
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Credential | MD
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Telephone | 732-677-2092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 25MA09531000
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License Number State | NJ
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