Provider Demographics
NPI:1164749065
Name:ELVIRA THOMAS
Entity Type:Organization
Organization Name:ELVIRA THOMAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MS
Authorized Official - First Name:ELVIRA
Authorized Official - Middle Name:JOANNA
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-538-7229
Mailing Address - Street 1:308 FENIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-1515
Mailing Address - Country:US
Mailing Address - Phone:516-538-7229
Mailing Address - Fax:
Practice Address - Street 1:308 FENIMORE AVE
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-1515
Practice Address - Country:US
Practice Address - Phone:516-538-7229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-01
Last Update Date:2010-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190158-1311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home