MEDICARE: VANESSA THOMPSON

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	363LA2200X	Adult Health Nurse Practitioner	312339	NY

General Provider Information

NPI Number	:	1154263366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA THOMPSON

Provider Business Mailing Address
First Line	:	14425 33RD AVE APT 4H
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-3103
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14425 33RD AVE APT 4H
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-3103
Country	:	US
Telephone Number	:	914-562-2463
Fax Number	:

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

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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Directions to “ VANESSA THOMPSON ” Practice Location

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