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Individual

SUSANNA THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1250 BOSTON POST RD, OLD SAYBROOK, CT 06475-4405
(860) 388-9250
(860) 388-9687
Mailing address
1250 BOSTON POST RD, OLD SAYBROOK, CT 06475-4405
(860) 388-9250
(860) 388-9687

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
028170
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010028170CT01
ANTHEM BLUE SHIELD
CT
01
028170
CONNECTICARE
CT
01
080121849
RAILROAD MEDICARE
CT
01
0R0177
HEALTHNET
CT
01
2143945
AETNA
CT
Enumeration date
08/11/2006
Last updated
12/15/2009
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