| Doctor Name: | JOEL DOUGLAS THOMAS |
| NPI Number: | 1134472137 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CNIM |
| License Number: | 1980 |
| Business Practice Address: | 1991 Marcus Ave Suite 108 Lake Success, NY - 11042 |
| Business Phone Number: | 5164422250 |
| Business Fax Number: | 5164422251 |
| Mailing Address: | 1991 Marcus Ave, Suite 108 LAKE SUCCESS |
| State: | NY |
| Postal Code: | 11042 |
| Phone Number: | 5164422250 |
| Fax Number: | 5164422251 |
| NPI Enumeration Date: | 10/16/2012 |
| NPI Last Update Date: | 10/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246ZE0600X |
| License Number: | 1980 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Specialist/Technologist, Other |
| Taxonomy Specialization: | Electroneurodiagnostic |
| Taxonomy Definition: | |