Provider Demographics
NPI:1992103063
Name:THOMAS, REMYA
Entity type:Individual
Prefix:
First Name:REMYA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CAPTAIN PARKER ARMS APT 23
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-7058
Mailing Address - Country:US
Mailing Address - Phone:603-937-5312
Mailing Address - Fax:
Practice Address - Street 1:17 CAPTAIN PARKER ARMS APT 23
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-7058
Practice Address - Country:US
Practice Address - Phone:603-937-5312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA4375225200000X
MA9933225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9933OtherPHYSICAL THERAPIST ASSISTANT MA LICENSE NUMBER
MEPA4375OtherPHYSICAL THERAPIST ASSISTANT LICENSE NUMBER