Provider Demographics
NPI:1912043092
Name:THOMAS, BINDU (OD)
Entity Type:Individual
Prefix:MS
First Name:BINDU
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 1ST AVE
Mailing Address - Street 2:APT #731
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6408
Mailing Address - Country:US
Mailing Address - Phone:917-597-7486
Mailing Address - Fax:
Practice Address - Street 1:25 W 43RD ST
Practice Address - Street 2:SUITE 316
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-7406
Practice Address - Country:US
Practice Address - Phone:212-921-1888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006692152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC310G1Medicare PIN