Justin Thai Thach, PA is a
Physician Assistant - Surgical based in College Point, New York. Justin Thai Thach is licensed to practice in New York (license number 012085) and his current practice location is
1217 119th St, College Point, New York. He can be reached at his office (for appointments etc.) via phone at
(646) 898-7446.
NPI number for Justin Thai Thach is 1558558395 and his current mailing address is 1217 119th St, College Point, New York. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1558558395.
Provider's Profile
| Full Name | Justin Thai Thach |
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| Gender | Male |
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| Speciality | Physician Assistant - Surgical |
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| Location | 1217 119th St, College Point, New York |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1558558395
- Provider Enumeration Date: 09/25/2007
- Last Update Date: 12/09/2015
Medical Identifiers
Medical identifiers for Justin Thai Thach such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1558558395 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363AS0400X | Physician Assistant - Surgical | 012085 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Justin Thai Thach is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Justin Thai Thach, PA
1217 119th St,
College Point, NY 11356-1648
Ph: (646) 898-7446 | Justin Thai Thach, PA
1217 119th St,
College Point, NY 11356-1648
Ph: (646) 898-7446 |
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