Latoya Clinie Thomas, | |
49 Wireless Blvd Ste 170, Hauppauge, NY 11788-3946 | |
(631) 382-7311 | |
(631) 382-7399 |
Full Name | Latoya Clinie Thomas |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 49 Wireless Blvd Ste 170, Hauppauge, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1447617709 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 039614-1 (New York) | Primary |
Provider Name | Affinity Rehabilitation Llp |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1346530169 PECOS PAC ID: 4789843376 Enrollment ID: O20120319000314 |
Mailing Address | Practice Location Address |
---|---|
Latoya Clinie Thomas, 49 Wireless Blvd Ste 170, Hauppauge, NY 11788-3946 Ph: (631) 382-7311 | Latoya Clinie Thomas, 49 Wireless Blvd Ste 170, Hauppauge, NY 11788-3946 Ph: (631) 382-7311 |
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