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General NPI Number Information
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NPI Number | 1811038607
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Entity Type | Organization
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Legal Business Name | D.E.T. MEDICAL P.C.
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8931 161ST ST
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City | JAMAICA
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State | NY
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Zip | 11432-6102
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Country | US
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Telephone | 718-526-1839
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Fax | 718-526-6169
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Provider Business Mailing Address
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Address Line | 8931 161ST ST
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City | JAMAICA
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State | NY
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Zip | 11432-6102
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Country | US
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Telephone | 718-526-1839
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Fax | 718-526-6169
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Authorized Official
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Title or Position | PRESI
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Name | DR. ERROL P THOMPSON
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Credential | MD
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Telephone | 718-526-1839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 207776
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License Number State | NY
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