MEDICARE: SULTANA THOMAS

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1548085483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SULTANA THOMAS

Provider Business Mailing Address
First Line	:	2567 TILTON RD APT B8
Second Line	:
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-1839
Country	:	US
Telephone Number	:	609-813-5055
Fax Number	:

Provider Business Practice Location Address
First Line	:	2567 TILTON RD APT B8
Second Line	:
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-1839
Country	:	US
Telephone Number	:	609-813-5055
Fax Number	:

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

Provider Enumeration Date	:	11/16/2024
Last Update Date	:	11/16/2024

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