Provider Demographics
NPI:1871156372
Name:NEAL-THOMAS, LYNETTE (TEACHER)
Entity type:Individual
Prefix:
First Name:LYNETTE
Middle Name:
Last Name:NEAL-THOMAS
Suffix:
Gender:F
Credentials:TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14514 222ND ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413-3460
Mailing Address - Country:US
Mailing Address - Phone:347-512-7625
Mailing Address - Fax:
Practice Address - Street 1:14514 222ND ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11413-3460
Practice Address - Country:US
Practice Address - Phone:347-512-7625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-19
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty