Individual
JACQUELINE HARRIS THAMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
80 ORVILLE DR STE 100, BOHEMIA, NY 11716-2505
(347) 599-8943
Mailing address
80 ORVILLE DR STE 100, BOHEMIA, NY 11716-2505
(934) 233-5455
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
0228161119-B
NY
Other
Enumeration date
02/16/2024
Last updated
02/16/2024
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