Individual
RICHARD THOMESEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4400
Mailing address
6 ASHLEY CT, EAST ISLIP, NY 11730-2215
(631) 261-4400
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401427
NY
Other
Enumeration date
01/26/2012
Last updated
01/26/2012
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