MEDICARE: REBECCA 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	171W00000X	Contractor		NY

General Provider Information

NPI Number	:	1942642780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA THOMAS

Provider Business Mailing Address
First Line	:	439 15TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-5703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	439 15TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-5703
Country	:	US
Telephone Number	:	347-703-9234
Fax Number	:

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

Provider Enumeration Date	:	07/22/2013
Last Update Date	:	07/22/2013

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Directions to “ REBECCA THOMAS ” Practice Location

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