Provider Demographics
NPI:1275879413
Name:THOMAS, SINJU (DPT)
Entity Type:Individual
Prefix:
First Name:SINJU
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 TRAILS END
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-1309
Mailing Address - Country:US
Mailing Address - Phone:845-323-4220
Mailing Address - Fax:
Practice Address - Street 1:28B INDIAN ROCK PLAZA
Practice Address - Street 2:ROUTE 59
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4907
Practice Address - Country:US
Practice Address - Phone:845-368-2108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-17
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032083225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist