Provider Demographics
NPI:1346508272
Name:THOMPSON, SEAN ALLEN CANTORNA (FNP)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:ALLEN CANTORNA
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 LEFFERTS PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-6199
Mailing Address - Country:US
Mailing Address - Phone:917-509-3583
Mailing Address - Fax:
Practice Address - Street 1:7901 4TH AVE STE A20
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3957
Practice Address - Country:US
Practice Address - Phone:718-491-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-28
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337109363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily