Individual
ELIZABETH THOTTUMALIL THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
93 WEST PALISADE AVE, ENGLEWOOD, NJ 07631
(201) 567-0500
Mailing address
93 W PALISADE AVE, ENGLEWOOD, NJ 07631-2611
(201) 567-0500
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0084808
—
NJ
Enumeration date
11/29/2017
Last updated
11/29/2017
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