MEDICARE: EASTERN MEDICAL ASSOCIATES, P.C.

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

General Provider Information

NPI Number	:	1801821251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASTERN MEDICAL ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	101 PROSPECT ST STE 212
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-5003
Country	:	US
Telephone Number	:	732-886-9400
Fax Number	:	732-905-7719

Provider Business Practice Location Address
First Line	:	101 PROSPECT ST STE 212
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-5003
Country	:	US
Telephone Number	:	732-886-9400
Fax Number	:	732-905-7719

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TERESA ELIZABETH THOMAS
Credential	:	M.D.
Telephone Number	:	732-886-9400

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	01/04/2011

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