Provider Demographics
NPI:1629283791
Name:THOMAS, KERA ANDREA (RPA-C)
Entity Type:Individual
Prefix:
First Name:KERA
Middle Name:ANDREA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:55 WATER STREET
Mailing Address - Street 2:2ND FLOOR CRED DEPT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10041-0004
Mailing Address - Country:US
Mailing Address - Phone:646-228-0690
Mailing Address - Fax:516-542-5556
Practice Address - Street 1:101 PENNSYLVANIA AVENUE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-2428
Practice Address - Country:US
Practice Address - Phone:718-240-2000
Practice Address - Fax:718-240-2260
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY010985363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant