Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | P03290 | NY |
Y | 111NI0900X | Internist | P03290 | NY |
NPI | 1003365859 |
---|---|
Provider Name | Dr. Naketa Thomas |
First Address | Brooklyn, NY 11237-4006 |
Second Address | Brooklyn, NY 11237-4006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2016 |
Last Update Date | 21/09/2016 |