Shanise Thomas

NPI #1023647013 in Ithaca, New York

Provider Information

NPI Number: 1023647013
Entity Type: Individual
Name: Shanise Thomas
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Apr 2, 2020
Last Updated: Nov 11, 2020

Practice Location

Address: 16 BRENTWOOD DR STE A
City: Ithaca
State: New York
ZIP Code: 14850-1863
Phone: (607) 272-7000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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