Provider Demographics
NPI:1699171686
Name:DIANNE THOMAS MD LLC
Entity type:Organization
Organization Name:DIANNE THOMAS MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-790-0086
Mailing Address - Street 1:165 STATE ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-5463
Mailing Address - Country:US
Mailing Address - Phone:201-790-0086
Mailing Address - Fax:201-457-1500
Practice Address - Street 1:165 STATE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-5463
Practice Address - Country:US
Practice Address - Phone:201-790-0086
Practice Address - Fax:201-457-1500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty