MEDICARE: NAQUAN THOMAS LMSW

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	104100000X	Social Worker	088369	NY
2	174400000X	Specialist	0883691	NY

General Provider Information

NPI Number	:	1740600089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAQUAN THOMAS LMSW

Provider Business Mailing Address
First Line	:	9511 102ND ST
Second Line	:
City	:	OZONE PARK
State	:	NY
Zip	:	11416-1713
Country	:	US
Telephone Number	:	718-473-6607
Fax Number	:

Provider Business Practice Location Address
First Line	:	9511 102ND ST
Second Line	:
City	:	OZONE PARK
State	:	NY
Zip	:	11416-1713
Country	:	US
Telephone Number	:	718-473-6607
Fax Number	:

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

Provider Enumeration Date	:	04/25/2014
Last Update Date	:	05/14/2026

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