Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MA38739 | NJ |
NPI | 1871569699 |
---|---|
Provider Name | Pauline A Thomas |
First Address | Berkeley Heights, NJ 07922-2104 |
Second Address | Berkeley Heights, NJ 07922-2104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 02/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H08784 | (02) | NJ |