MEDICARE: DR. CHERIYAN THOMAS M.D

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	268633	NY

General Provider Information

NPI Number	:	1619248481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERIYAN THOMAS M.D

Provider Business Mailing Address
First Line	:	230 HILTON AVE STE 106
Second Line	:
City	:	HEMPSTEAD
State	:	NY
Zip	:	11550-8116
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 HILTON AVE STE 106
Second Line	:
City	:	HEMPSTEAD
State	:	NY
Zip	:	11550-8116
Country	:	US
Telephone Number	:	516-849-4678
Fax Number	:

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

Provider Enumeration Date	:	01/25/2012
Last Update Date	:	03/30/2023

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