Doctor Name: | SANDRA THOMAS |
NPI Number: | 1003161183 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | F305109-1 |
Business Practice Address: | 235 N Belle Mead Rd East Setauket, NY - 117333456 |
Business Phone Number: | 6317244664 |
Business Fax Number: | |
Mailing Address: | 65 Church Ln, MIDDLE ISLAND |
State: | NY |
Postal Code: | 119531705 |
Phone Number: | 6319241738 |
Fax Number: | |
NPI Enumeration Date: | 07/16/2012 |
NPI Last Update Date: | 01/26/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | F305109-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |