Provider Demographics
NPI:1134643323
Name:THOMAS, JEFFREY M (APN)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:M
Last Name:THOMAS
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:849 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-5325
Mailing Address - Country:US
Mailing Address - Phone:732-668-6196
Mailing Address - Fax:609-739-8926
Practice Address - Street 1:849 W STATE ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-5325
Practice Address - Country:US
Practice Address - Phone:732-668-6196
Practice Address - Fax:609-739-8926
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY348383363L00000X
PASP017943363L00000X
NJ26NJ00749300363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner