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NPI Code Detail

MEDICARE: MS. EMILY ROSE THOMAS

MEDICARE:  MS. EMILY ROSE 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1548825334
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. EMILY ROSE THOMAS
Provider Business Mailing Address
First Line : 209 W 97TH ST APT 1E
Second Line :
City : NEW YORK
State : NY
Zip : 10025-5602
Country : US
Telephone Number : 845-536-0712
Fax Number :
Provider Business Practice Location Address
First Line : 146-28 JASMINE AVE
Second Line :
City : FLUSHING
State : NY
Zip : 11355-2248
Country : US
Telephone Number : 718-352-0104
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2019
Last Update Date : 05/07/2019

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Directions to “ MS. EMILY ROSE THOMAS ” Practice Location

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