Individual
MARY MEENA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
375 EAST MAIN STREET, SUITE 21, BAY SHORE, NY 11706
(631) 968-8288
(631) 968-8268
Mailing address
375 EAST MAIN STREET, SUITE 21, BAY SHORE, NY 11706
(631) 968-8288
(631) 968-8268
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
216878
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02590774
—
NY
Enumeration date
08/17/2006
Last updated
03/10/2011
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