Individual
CRYSTAL NICOLE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 NICOLLS RD RM 80, STONY BROOK, NY 11794-8350
(631) 444-2478
Mailing address
PO BOX 1554, STONY BROOK, NY 11790-0988
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
288947-1
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2014
Last updated
03/17/2018
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