Provider Demographics
NPI:1588103774
Name:CONCERT, THOMAS J (DNP, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:CONCERT
Suffix:
Gender:M
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 2ND AVE RM 806
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-9223
Mailing Address - Country:US
Mailing Address - Phone:646-799-9450
Mailing Address - Fax:
Practice Address - Street 1:800 2ND AVE RM 806
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-9223
Practice Address - Country:US
Practice Address - Phone:646-799-9450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2021-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY341508363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily