Provider Demographics
NPI:1114786381
Name:THOMSON, ZOE LOUISA
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:LOUISA
Last Name:THOMSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MAPLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ULSTER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12487-5372
Mailing Address - Country:US
Mailing Address - Phone:845-372-4619
Mailing Address - Fax:
Practice Address - Street 1:100 MAPLE RIDGE DR
Practice Address - Street 2:
Practice Address - City:ULSTER PARK
Practice Address - State:NY
Practice Address - Zip Code:12487-5372
Practice Address - Country:US
Practice Address - Phone:845-372-4619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program