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General NPI Number Information
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NPI Number | 1891370243
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Entity Type | Organization
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Legal Business Name | THOMAS FAMILY PRACTICE FAMILY HEALTH NP SERVICES PLLC
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Dates
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Enumeration Date | 03/16/2021
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Last Update Date | 06/29/2021
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Provider Practice Location Address
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Address Line | 6 GRAMATAN AVE STE 402
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City | MOUNT VERNON
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State | NY
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Zip | 10550-3209
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Country | US
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Telephone | 914-434-3641
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Fax |
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Provider Business Mailing Address
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Address Line | 6 GRAMATAN AVE STE 402
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City | MOUNT VERNON
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State | NY
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Zip | 10550-3209
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Country | US
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Telephone | 914-434-3641
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Fax |
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Authorized Official
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Title or Position | NP/OWNER
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Name | SHAUNTAY THOMAS
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Credential |
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Telephone | 914-434-3641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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