Most Relevant Information
Provider Data
| NPI Number: | 1003800566 |
| Provider Name: | MARY JEAN THOMAS FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | F330382 |
Most Important Dates
| Enumeration Date: | 09/09/2005 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
736 IRVING AVE
SYRACUSE
NY
132101687
Practice Location Phone/Fax
| Phone: | 3154707111 |
| Fax: |
Provider Mailing Location
4140 TOMMYS TRL
LIVERPOOL
NY
130903737
Provider Mailing Phone/Fax
| Phone: | 3154512997 |
| Fax: |