MEDICARE: DR. JOSEPH THOMAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	113843	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073505012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH THOMAS MD

Provider Business Mailing Address
First Line	:	1344 MIDDLE COUNTRY RD
Second Line	:
City	:	CENTEREACH
State	:	NY
Zip	:	11720-3583
Country	:	US
Telephone Number	:	631-698-4932
Fax Number	:	631-698-2453

Provider Business Practice Location Address
First Line	:	1344 MIDDLE COUNTRY RD
Second Line	:
City	:	CENTEREACH
State	:	NY
Zip	:	11720-3583
Country	:	US
Telephone Number	:	631-698-4932
Fax Number	:	631-698-2453

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	07/08/2007

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