Provider Demographics
NPI:1790159283
Name:THOMAS PEDIATRICS LLC
Entity Type:Organization
Organization Name:THOMAS PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:USHA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-677-2092
Mailing Address - Street 1:654 NEWMAN SPRINGS ROAD
Mailing Address - Street 2:SUITE E
Mailing Address - City:LINCROFT
Mailing Address - State:NJ
Mailing Address - Zip Code:07738
Mailing Address - Country:US
Mailing Address - Phone:732-677-2092
Mailing Address - Fax:732-383-7952
Practice Address - Street 1:654 NEWMAN SPRINGS ROAD
Practice Address - Street 2:SUITE E
Practice Address - City:LINCROFT
Practice Address - State:NJ
Practice Address - Zip Code:07738
Practice Address - Country:US
Practice Address - Phone:732-677-2092
Practice Address - Fax:732-383-7952
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THOMAS PEDIATRICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-20
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09531000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty