Individual
JOHN THOMASSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
009938-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027548
VALUE OPTIONS
—
01
—
156779FC
PREFERRED CARE
NY
01
—
7283460
AENTA
NY
Enumeration date
01/19/2007
Last updated
07/09/2007
Update your record
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