Doctor Name: | ALEX THAYIL THOMAS |
NPI Number: | 1124375035 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 022410 |
Business Practice Address: | 3100 47th Avenue 2120 D Long Island City, NY - 111012302 |
Business Phone Number: | 9179957510 |
Business Fax Number: | |
Mailing Address: | 3100 47th Avenue #2120 D (2nd Floor), Allied Medix Resources Inc. LONG ISLAND CITY |
State: | NY |
Postal Code: | 111012302 |
Phone Number: | 9179957510 |
Fax Number: | |
NPI Enumeration Date: | 08/09/2012 |
NPI Last Update Date: | 01/14/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 022410 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |