Provider Demographics
NPI:1659519346
Name:THOMAS, PATRICIA JANN (DO)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:JANN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:798 CENTERTON RD
Mailing Address - Street 2:
Mailing Address - City:ELMER
Mailing Address - State:NJ
Mailing Address - Zip Code:08318-3945
Mailing Address - Country:US
Mailing Address - Phone:856-358-6161
Mailing Address - Fax:
Practice Address - Street 1:798 CENTERTON RD
Practice Address - Street 2:
Practice Address - City:ELMER
Practice Address - State:NJ
Practice Address - Zip Code:08318-3945
Practice Address - Country:US
Practice Address - Phone:856-358-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-03
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAOT013278207Q00000X
NJ25MB09125300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program