Provider Demographics
NPI:1083664916
Name:THOMANN, KELLY H (OD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:H
Last Name:THOMANN
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:2 ACKERMAN CT
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-2027
Mailing Address - Country:US
Mailing Address - Phone:914-760-6871
Mailing Address - Fax:914-788-4373
Practice Address - Street 1:ALBANY POST ROAD
Practice Address - Street 2:VA HUDSON VALLEY HEALTHCARE SYSTEM
Practice Address - City:MONTROSE
Practice Address - State:NY
Practice Address - Zip Code:10548
Practice Address - Country:US
Practice Address - Phone:914-737-4400
Practice Address - Fax:914-788-4373
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYVUT5035152W00000X
TN2324152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist