Provider Demographics
NPI:1215067392
Name:THOMSEN, KATHLEEN M (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:M
Last Name:THOMSEN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 W DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-1603
Mailing Address - Country:US
Mailing Address - Phone:609-818-9700
Mailing Address - Fax:609-818-9811
Practice Address - Street 1:252 W DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-1603
Practice Address - Country:US
Practice Address - Phone:609-818-9700
Practice Address - Fax:609-818-9811
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJDO53965OtherCDS
NJDO53965OtherCDS
NJDO53965OtherCDS