Provider Demographics
NPI:1235952540
Name:THOMAS, MANOJ (RN)
Entity type:Individual
Prefix:
First Name:MANOJ
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7605 CHELSEA CV N
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-7127
Mailing Address - Country:US
Mailing Address - Phone:845-870-0958
Mailing Address - Fax:
Practice Address - Street 1:7605 CHELSEA CV N
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-7127
Practice Address - Country:US
Practice Address - Phone:845-870-0958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY584645163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health