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NPI Code Detail

MEDICARE: TISHA ANN THOMAS FNP-BC

MEDICARE:   TISHA ANN THOMAS  FNP-BC
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
1363LF0000XFamily Nurse PractitionerF342947-1NY

General Provider Information

NPI Number : 1649763418
Entity Type Code : Individual
Provider Name (Legal Business Name) : TISHA ANN THOMAS FNP-BC
Provider Business Mailing Address
First Line : 472 BRONXVILLE RD
Second Line :
City : BRONXVILLE
State : NY
Zip : 10708-1115
Country : US
Telephone Number : 914-602-7540
Fax Number :
Provider Business Practice Location Address
First Line : 250 BEDFORD PARK BLVD W
Second Line :
City : BRONX
State : NY
Zip : 10468-1527
Country : US
Telephone Number : 718-960-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2018
Last Update Date : 06/07/2018

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Directions to “ TISHA ANN THOMAS FNP-BC” Practice Location

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