Provider Demographics
NPI:1609393362
Name:THOMPSON, GARRETT (AUD)
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 E 58TH ST STE 411
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1166
Mailing Address - Country:US
Mailing Address - Phone:212-752-3373
Mailing Address - Fax:212-752-7192
Practice Address - Street 1:133 E 58TH ST
Practice Address - Street 2:SUITE 411
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022
Practice Address - Country:US
Practice Address - Phone:212-752-3373
Practice Address - Fax:212-752-7192
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002752231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist