MEDICARE: MATTHEW ROBERT 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	207P00000X	Emergency Medicine Physician	0101270117	VA
2	207P00000X	Emergency Medicine Physician	306412	NY

General Provider Information

NPI Number	:	1700319357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW ROBERT THOMAS

Provider Business Mailing Address
First Line	:	186 NASSAU AVE APT 2L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11222-4179
Country	:	US
Telephone Number	:	443-761-1260
Fax Number	:

Provider Business Practice Location Address
First Line	:	355 BARD AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10310-1699
Country	:	US
Telephone Number	:	718-818-1234
Fax Number	:

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

Provider Enumeration Date	:	04/10/2017
Last Update Date	:	05/11/2022

Similar Medicare Providers

1316806177 — LATHIFA MADY NNAP MD
Practice Location Address:

355 BARD AVE DEPT OF
STATEN ISLAND, NY
10310-1699

Practice Phone: 718-818-2419
Practice Fax:

1619124823 — DR. MELISSA RENEE RICAFRENTE GRAGEDA M.D.
Practice Location Address:

355 BARD AVE
STATEN ISLAND, NY
10310-1699

Practice Phone: 718-818-4636
Practice Fax:

1841505187 — MELISSA GUILLERMO MD
Practice Location Address:

355 BARD AVE RM 314
STATEN ISLAND, NY
10310-1699

Practice Phone: 718-818-4636
Practice Fax: 718-818-2739

1861757932 — DR. FIONA SHEHAJ MD
Practice Location Address:

355 BARD AVE
STATEN ISLAND, NY
10310-1699

Practice Phone: 718-818-3249
Practice Fax:

1467797753 — JENNY SHMUSHKEVICH CRNA
Practice Location Address:

355 BARD AVE
STATEN ISLAND, NY
10310-1699

Practice Phone: 718-818-1234
Practice Fax:

1952734063 — NANCY ELLIS LCSW
Practice Location Address:

355 BARD AVE
STATEN ISLAND, NY
10310-1699

Practice Phone: 718-818-7010
Practice Fax: 718-876-7013

Directions to “ MATTHEW ROBERT THOMAS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.