Provider Demographics
NPI:1396052015
Name:NORTHEAST HAND SPECIALISTS LLC
Entity type:Organization
Organization Name:NORTHEAST HAND SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HAND SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-940-4263
Mailing Address - Street 1:PO BOX 286116
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0011
Mailing Address - Country:US
Mailing Address - Phone:206-940-4263
Mailing Address - Fax:866-308-4263
Practice Address - Street 1:3016 30TH DR
Practice Address - Street 2:3RD FLOOR
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-1874
Practice Address - Country:US
Practice Address - Phone:206-940-4263
Practice Address - Fax:866-308-4263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-01
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219039174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty