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NPI Code Detail

MEDICARE: DR. JILL B THOMPSON MD

MEDICARE: DR. JILL B THOMPSON 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
1207VG0400XGynecology Physician209825NY

Other Identifiers

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

General Provider Information

NPI Number : 1427022557
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JILL B THOMPSON MD
Provider Business Mailing Address
First Line : 50 MAKAMAH BEACH RD
Second Line :
City : NORTHPORT
State : NY
Zip : 11768-1339
Country : US
Telephone Number : 631-754-4200
Fax Number : 631-754-4414
Provider Business Practice Location Address
First Line : 847A FORT SALONGA RD
Second Line :
City : NORTHPORT
State : NY
Zip : 11768-2252
Country : US
Telephone Number : 631-754-4200
Fax Number : 631-754-4414
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 07/08/2007

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