Individual
KHADIYYAH THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
17 DARTMOUTH AVE APT 4A, BRIDGEWATER, NJ 08807-3425
(908) 357-7939
Mailing address
17 DARTMOUTH AVE APT 4A, BRIDGEWATER, NJ 08807-3425
(908) 357-7939
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NP06783800
NJ
Other
Enumeration date
05/05/2018
Last updated
05/05/2018
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