Provider Demographics
NPI:1861239972
Name:THOMAS, ROBERT W JR
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:W
Last Name:THOMAS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3886 E 155TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-1271
Mailing Address - Country:US
Mailing Address - Phone:216-224-5755
Mailing Address - Fax:
Practice Address - Street 1:3886 E 155TH ST APT 2
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-1271
Practice Address - Country:US
Practice Address - Phone:216-224-5755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide