Provider Demographics
NPI:1932420270
Name:THOMAS, MONICA DESIREE (RN)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:DESIREE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:MONICA
Other - Middle Name:DESIREE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:14551 180TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-5036
Mailing Address - Country:US
Mailing Address - Phone:917-407-0458
Mailing Address - Fax:
Practice Address - Street 1:14551 180TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-5036
Practice Address - Country:US
Practice Address - Phone:917-407-0458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY623558163WH0200X, 372600000X, 3747P1801X, 374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide