Provider Demographics
NPI:1922048248
Name:THOMAS, FLORENTINE ELNA (MD)
Entity Type:Individual
Prefix:
First Name:FLORENTINE
Middle Name:ELNA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 NORTH CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770
Mailing Address - Country:US
Mailing Address - Phone:203-729-2186
Mailing Address - Fax:203-729-2660
Practice Address - Street 1:577 NORTH CHURCH ST
Practice Address - Street 2:
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770
Practice Address - Country:US
Practice Address - Phone:203-729-2186
Practice Address - Fax:203-729-2660
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT025382208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics