Provider Demographics
NPI:1083310841
Name:THOMAS, JAYCY (NP)
Entity Type:Individual
Prefix:
First Name:JAYCY
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:JAYCY
Other - Middle Name:THOMAS
Other - Last Name:SOHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:14 WALL ST FL 9
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005-2178
Mailing Address - Country:US
Mailing Address - Phone:646-501-3229
Mailing Address - Fax:
Practice Address - Street 1:1111 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1617
Practice Address - Country:US
Practice Address - Phone:516-663-3511
Practice Address - Fax:516-663-4780
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY351217363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily