Provider Demographics
NPI:1275856361
Name:THOMAS, JOCELYN C
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:C
Last Name:THOMAS
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 1:610 E MALLOY BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SEAGOVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75159-1818
Mailing Address - Country:US
Mailing Address - Phone:972-287-1134
Mailing Address - Fax:
Practice Address - Street 1:8345 LANGDALE ST
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1822
Practice Address - Country:US
Practice Address - Phone:718-470-0208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-04
Last Update Date:2022-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054039183500000X
TX62582183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist