Provider Demographics
NPI:1932886256
Name:THOMAS, EBONY PATRICE
Entity Type:Individual
Prefix:
First Name:EBONY
Middle Name:PATRICE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 NEWTON ST NW # G1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3103
Mailing Address - Country:US
Mailing Address - Phone:202-277-3146
Mailing Address - Fax:
Practice Address - Street 1:3721 DONNELL DR APT 304
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:MD
Practice Address - Zip Code:20747-3931
Practice Address - Country:US
Practice Address - Phone:202-277-3146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide