Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | F341658-1 | NY |
NPI | 1003303561 |
---|---|
Provider Name | Ms. Rashana P Thompson |
First Address | Bronx, NY 10453-4303 |
Second Address | Bronx, NY 10453 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2018 |
Last Update Date | 31/05/2018 |