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Individual

JAYA PAPPALY THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7925 WINCHESTER BLVD, QUEENS VILLAGE, NY 11427-2128
(718) 264-4050
Mailing address
998 CROOKED HILL RD, BRENTWOOD, NY 11717-1019
(631) 761-3622
(631) 761-2816

Taxonomy

Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
548825
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403290
NY

Other

Enumeration date
01/30/2018
Last updated
08/22/2024
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