MEDICARE: MRS. SHEILLA THOMAS N.P.

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	363LA2200X	Adult Health Nurse Practitioner	F-304127-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760446553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHEILLA THOMAS N.P.

Provider Business Mailing Address
First Line	:	3435 MAIN ST
Second Line	:	MICHAEL HALL
City	:	BUFFALO
State	:	NY
Zip	:	14214-3001
Country	:	US
Telephone Number	:	716-829-3316
Fax Number	:	716-829-2564

Provider Business Practice Location Address
First Line	:	3435 MAIN ST
Second Line	:	MICHAEL HALL
City	:	BUFFALO
State	:	NY
Zip	:	14214-3001
Country	:	US
Telephone Number	:	716-829-3316
Fax Number	:	716-289-2564

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

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	11/17/2008

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