Provider Demographics
NPI:1659578797
Name:THOMAS, JHIBU (MD)
Entity Type:Individual
Prefix:
First Name:JHIBU
Middle Name:
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 1:2222 ROUTE 33
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-1752
Mailing Address - Country:US
Mailing Address - Phone:609-890-4100
Mailing Address - Fax:609-890-4189
Practice Address - Street 1:2222 ROUTE 33
Practice Address - Street 2:SUITE H
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-1752
Practice Address - Country:US
Practice Address - Phone:609-890-4100
Practice Address - Fax:609-890-4189
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08277000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0439706OtherEVERCARE
522117147OtherTRICARE
5221142040OtherBCBS OF NJ
522117147OtherTRICARE
NJ120243PU2Medicare PIN