Provider Demographics
NPI:1043274350
Name:THOMAS, KURT FLORIAN P (MD, MA, PHD, MS)
Entity Type:Individual
Prefix:PROF
First Name:KURT FLORIAN
Middle Name:P
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD, MA, PHD, MS
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Mailing Address - Street 1:30 PROSPECT AVE
Mailing Address - Street 2:NEUROSCIENCE INSTITUTE, HACKENSACKUMC
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1915
Mailing Address - Country:US
Mailing Address - Phone:314-706-6488
Mailing Address - Fax:
Practice Address - Street 1:30 PROSPECT AVE
Practice Address - Street 2:NEUROSCIENCE INSTITUTE, HACKENSACKUMC
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1915
Practice Address - Country:US
Practice Address - Phone:314-706-6488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMD1086452081P0004X, 2084N0400X
NJ25MA099142002081P0004X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOF46-220Medicare UPIN