1538513296 NPI number — DR. GINU AYKKARETH THOMAS

Table of content: DR. GINU AYKKARETH THOMAS (NPI 1538513296)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538513296 NPI number — DR. GINU AYKKARETH THOMAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AYKKARETH THOMAS
Provider First Name:
GINU
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538513296
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
AYKKARETH HOUSE, PANDANAD NORTH P O
Provider Second Line Business Mailing Address:
KALLISSERY
Provider Business Mailing Address City Name:
CHENGANOOR
Provider Business Mailing Address State Name:
KERALA
Provider Business Mailing Address Postal Code:
689124
Provider Business Mailing Address Country Code:
IN
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 GUTHRIE SQ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAYRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18840-1625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-887-3585
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/19/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: MD2021-1141 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085N0700X , with the licence number: MD2021-1141 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com