MEDICARE: THOMPSON MEDICAL, P.C.

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	207X00000X	Orthopaedic Surgery Physician	253711	NY
2	207X00000X	Orthopaedic Surgery Physician	25MA08975400	NJ

General Provider Information

NPI Number	:	1285975771
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMPSON MEDICAL, P.C.

Provider Business Mailing Address
First Line	:	65-11 BOOTH STREET SUITE 1C
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374
Country	:	US
Telephone Number	:	718-806-1434
Fax Number	:	718-806-1435

Provider Business Practice Location Address
First Line	:	855 LEHIGH AVE
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-7631
Country	:	US
Telephone Number	:	212-388-9500
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. SEAN L THOMPSON
Credential	:	MD
Telephone Number	:	718-806-1434

Provider Enumeration Date	:	03/07/2013
Last Update Date	:	10/10/2016

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