MEDICARE: THOMAS MJ NIEDERMAN MD,PHD

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	174400000X	Specialist	ME80006	FL

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	:	1992762868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS MJ NIEDERMAN MD,PHD

Provider Business Mailing Address
First Line	:	2240 W WOOLBRIGHT RD
Second Line	:	SUITE 415
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-6332
Country	:	US
Telephone Number	:	561-737-6556
Fax Number	:

Provider Business Practice Location Address
First Line	:	2240 W WOOLBRIGHT RD
Second Line	:	SUITE 415
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-6332
Country	:	US
Telephone Number	:	561-737-6556
Fax Number	:

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	04/07/2010

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