Individual
MR. JOHN THOMAS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2209 GENESEE ST, UTICA, NY 13501-5930
(315) 734-4408
(315) 798-8397
Mailing address
2209 GENESEE ST, UTICA, NY 13501-5930
(315) 734-4408
(315) 798-8397
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
152233-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01910916
—
NY
Enumeration date
10/03/2005
Last updated
07/09/2007
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