Individual
ASHANTI THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11311 JAMAICA AVE, RICHMOND HILL, NY 11418-2476
(929) 376-2548
Mailing address
11311 JAMAICA AVE, RICHMOND HILL, NY 11418-2476
(631) 933-7825
Taxonomy
Speciality
Code
Description
License number
State
261QR0800X
Recovery Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
852822489
—
NY
Enumeration date
05/08/2024
Last updated
05/08/2024
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