Provider Demographics
NPI:1639193691
Name:THOMPSON, ERROL P (MD)
Entity Type:Individual
Prefix:DR
First Name:ERROL
Middle Name:P
Last Name:THOMPSON
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 1:89 31 161 STREET
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432
Mailing Address - Country:US
Mailing Address - Phone:718-526-1839
Mailing Address - Fax:718-526-6169
Practice Address - Street 1:8931 161ST ST
Practice Address - Street 2:DET MEDICAL P.C.
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-6102
Practice Address - Country:US
Practice Address - Phone:718-526-1839
Practice Address - Fax:718-526-6169
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207776207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1000017464OtherAFFINITY
NY207776-NYOther1199NBF
NY207776E17OtherHEALTHFIRST
NY01771580Medicaid
NY317680501OtherHEALTHPLUS
NY010137202OtherAMERICHOICE OF NY
NY113584832TH02OtherCAREPLUS, INC
NY207776OtherHIP
NY113584832TH01OtherCAREPLUS, INC
NY317680401OtherHEALTHPLUS
NY0298756OtherGHI
NY72N351OtherEMPIRE BLUE CROSSBS
NY010137201OtherAMERICHOICE OF NY
NY2010368OtherCIGNA
NY317680401OtherHEALTHPLUS
NY05665GMedicare ID - Type Unspecified