MEDICARE: DR. THOMAS PRICE 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
1	207R00000X	Internal Medicine Physician	133980	NY
2	207RC0000X	Cardiovascular Disease Physician	133980	NY

General Provider Information

NPI Number	:	1568525160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS PRICE MD

Provider Business Mailing Address
First Line	:	105 STEVENS AVE
Second Line	:	6TH FLOOR
City	:	MT VERNON
State	:	NY
Zip	:	10550-2686
Country	:	US
Telephone Number	:	914-664-4052
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 STEVENS AVE
Second Line	:	6TH FLOOR
City	:	MT VERNON
State	:	NY
Zip	:	10550-2686
Country	:	US
Telephone Number	:	914-664-4052
Fax Number	:

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

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	10/06/2021

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