Individual
SUSAN THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-8484
(215) 707-3946
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-8484
(215) 707-3946
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP012502
PA
Other
Enumeration date
01/31/2013
Last updated
04/06/2017
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