Basic Information
Provider Information | |||||||||
NPI: | 1346568128 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | THOMAS | ||||||||
FirstName: | SARUN | ||||||||
MiddleName: | VARUGHESE | ||||||||
NamePrefix: | MR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | D.O. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 353 EAST 17TH STREET | ||||||||
Address2: | 2ND FLOOR ROOM 223 | ||||||||
City: | NEW YORK | ||||||||
State: | NY | ||||||||
PostalCode: | 10003 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2124203743 | ||||||||
FaxNumber: | 6104476373 | ||||||||
Practice Location | |||||||||
Address1: | 353 EAST 17TH STREET | ||||||||
Address2: | 2ND FLOOR ROOM 223 | ||||||||
City: | NEW YORK | ||||||||
State: | NY | ||||||||
PostalCode: | 10003 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2124203743 | ||||||||
FaxNumber: | 6104476373 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/04/2010 | ||||||||
LastUpdateDate: | 03/26/2016 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | OT013367 | PA | N |   | Student, Health Care | Student in an Organized Health Care Education/Training Program |   | 207RP1001X | 283304 | NY | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RC0200X | 283304 | NY | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
No ID Information.