Individual
ODETTE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
259 1ST ST, MINEOLA, NY 11501-3957
(516) 663-8963
(516) 663-8964
Mailing address
259 1ST ST, MINEOLA, NY 11501-3957
(516) 663-8963
(516) 663-8964
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
062614
GA
208M00000X
Hospitalist Physician
Primary
264712
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
752272394A
—
GA
Enumeration date
08/18/2008
Last updated
02/01/2017
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