Provider Demographics
NPI:1437595691
Name:THOMAS, MERIN SARA (FNP)
Entity Type:Individual
Prefix:
First Name:MERIN
Middle Name:SARA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MERIN
Other - Middle Name:SARA
Other - Last Name:MATHAI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:919 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1206
Mailing Address - Country:US
Mailing Address - Phone:914-519-8136
Mailing Address - Fax:
Practice Address - Street 1:919 N BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1206
Practice Address - Country:US
Practice Address - Phone:914-519-8136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY337938363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily