Individual
DR. THOMAS KINCADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
104 MARKET ST, PERTH AMBOY, NJ 08861-4412
(732) 826-5159
(732) 826-2107
Mailing address
104 MARKET ST, PERTH AMBOY, NJ 08861-4412
(732) 826-5159
(732) 826-2107
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
220654-1
NY
207W00000X
Ophthalmology Physician
Primary
25MA03354000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8198101
—
NJ
Enumeration date
09/01/2006
Last updated
05/20/2011
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