Provider Demographics
NPI:1295196327
Name:THOMAS, MONICA (PHD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 PUTNAM HALL DEPARTMENT OF PSYCHIATRY
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-5528
Mailing Address - Country:US
Mailing Address - Phone:631-632-2428
Mailing Address - Fax:
Practice Address - Street 1:169 PUTNAM HALL DEPARTMENT OF PSYCHIATRY
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-5528
Practice Address - Country:US
Practice Address - Phone:631-632-2428
Practice Address - Fax:631-216-8319
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-17
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021855103TA0400X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)