National Provider Identifier

Shanise Thomas

Shanise Thomas is listed in the NPPES registry with a primary specialty of Physician Assistant in Ithaca, NY and a listed phone number of (607) 272-7000.

NPI 1023647013Ithaca, NYPhysician Assistant

Source: public NPPES record, last updated November 11, 2020. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.

Profile Overview

NPI
1023647013
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
April 02, 2020
Last Updated
November 11, 2020

Practice Location

  • 16 Brentwood Dr Ste A
  • Ithaca, NY 14850-1863

Phone: (607) 272-7000

Specialties

  • Physician Assistant (363A00000X)

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Full Record
NPI
1023647013
Entity Type
Individual
Last Name
Thomas
First Name
Shanise
Mailing Street Address
16 Brentwood Dr Ste A
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850-1863
Mailing Country
US
Practice Street Address
16 Brentwood Dr Ste A
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-1863
Practice Country
US
Practice Phone
(607) 272-7000
Enumeration Date
April 02, 2020
Last Updated
November 11, 2020
Sex
Female
Sole Proprietor
No
Certification Date
November 11, 2020
Taxonomies
Physician Assistant (363A00000X)