| Dianne Thomas Md Llc | |
|
165 State St Suite 2 Hackensack NJ 07601-5463 | |
| (201) 790-0086 | |
| (201) 457-1500 |
| Full Name | Dianne Thomas Md Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 165 State St, Hackensack, New Jersey |
| Authorized Official Name and Position | Dianne Thomas (OWNER) |
| Authorized Official Contact | 2017900086 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dianne Thomas Md Llc 165 State St Suite 2 Hackensack NJ 07601-5463 Ph: (201) 790-0086 | Dianne Thomas Md Llc 165 State St Suite 2 Hackensack NJ 07601-5463 Ph: (201) 790-0086 |
| NPI Number | 1699171686 |
|---|---|
| Provider Enumeration Date | 11/18/2014 |
| Last Update Date | 11/18/2014 |
| Medicare PECOS PAC ID | 5294057832 |
|---|---|
| Medicare Enrollment ID | O20141209002389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699171686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Dianne Thomas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669689360 PECOS PAC ID: 0345277406 Enrollment ID: I20050720000404 |
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