Provider Demographics
NPI:1881881340
Name:THOMAS J. JOYCE, D.O., LLC
Entity type:Organization
Organization Name:THOMAS J. JOYCE, D.O., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEARL
Authorized Official - Middle Name:S
Authorized Official - Last Name:SUSSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-374-4211
Mailing Address - Street 1:33 FROST LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1808
Mailing Address - Country:US
Mailing Address - Phone:516-374-4211
Mailing Address - Fax:
Practice Address - Street 1:33 FROST LN
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1808
Practice Address - Country:US
Practice Address - Phone:516-374-4211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WER401Medicare PIN