Provider Demographics
NPI:1104845023
Name:THOMPSON, JOHN F (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:111 E 210TH ST
Mailing Address - Street 2:ROSENTHAL 3-333
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2401
Mailing Address - Country:US
Mailing Address - Phone:718-741-2332
Mailing Address - Fax:718-515-5426
Practice Address - Street 1:3415 BAINBRIDGE AVE
Practice Address - Street 2:CHILDREN'S HOSPITAL AT MONTEFIORE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2403
Practice Address - Country:US
Practice Address - Phone:718-741-2332
Practice Address - Fax:718-515-5426
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2011-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME689982080P0206X
NY1499162080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03140567Medicaid
FL3738540-00Medicaid
FLE01850Medicare UPIN
NY03140567Medicaid
NYA400018245Medicare PIN