Individual
MR. TODD ANDREW THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 MEMORIAL DR, GOWANDA, NY 14070-1111
(716) 532-8729
Mailing address
BERTRAND CHAFFEE HOSPITAL, E 224 MAIN STREET, SPRINGVILLE, NY 14141
(716) 201-0055
(866) 898-3409
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
006374
NY
363AM0700X
Medical Physician Assistant
Primary
23-006374
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006374
PA NYS LICENSE
NY
05
—
02936510
—
NY
Enumeration date
09/17/2006
Last updated
03/08/2019
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