Provider Demographics
NPI:1669763785
Name:THYMA, SUCAINA LUCRECE (RN)
Entity type:Individual
Prefix:MRS
First Name:SUCAINA
Middle Name:LUCRECE
Last Name:THYMA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 SUSSEX RD
Mailing Address - Street 2:PH
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-2034
Mailing Address - Country:US
Mailing Address - Phone:516-444-1707
Mailing Address - Fax:
Practice Address - Street 1:195 SUSSEX RD
Practice Address - Street 2:PH
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-2034
Practice Address - Country:US
Practice Address - Phone:516-444-1707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-23
Last Update Date:2011-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY641885-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse