Provider Demographics
NPI:1144562927
Name:MARY JO THOMAS OD LLC
Entity Type:Organization
Organization Name:MARY JO THOMAS OD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY JO
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-968-2330
Mailing Address - Street 1:119 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-2047
Mailing Address - Country:US
Mailing Address - Phone:215-968-2330
Mailing Address - Fax:215-579-1673
Practice Address - Street 1:119 N STATE ST
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-2047
Practice Address - Country:US
Practice Address - Phone:215-968-2330
Practice Address - Fax:215-579-1673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty