Provider Demographics
NPI:1609040641
Name:THOMAS, ANIL ABRAHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ANIL
Middle Name:ABRAHAM
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 MAIN ST
Mailing Address - Street 2:SUITE #7F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10044-0353
Mailing Address - Country:US
Mailing Address - Phone:212-361-9018
Mailing Address - Fax:
Practice Address - Street 1:415 MAIN ST APT 7F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10044-0356
Practice Address - Country:US
Practice Address - Phone:212-361-9018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA113545002084P0802X
NY0030112084P0802X
NY2741552084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA11354500OtherNJ