Provider Demographics
NPI:1407813074
Name:THOMAS, JAMES (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 ASHBURN RD
Mailing Address - Street 2:WAYNE
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2642
Mailing Address - Country:US
Mailing Address - Phone:973-956-0615
Mailing Address - Fax:973-341-6114
Practice Address - Street 1:24 ASHBURN RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2642
Practice Address - Country:US
Practice Address - Phone:973-956-0615
Practice Address - Fax:973-341-6114
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196092207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01655792Medicaid
NYG38670Medicare UPIN
NY01655792Medicaid