Provider Demographics
NPI:1437387586
Name:THOMAS, JESSY JOYKUTTY (MD)
Entity type:Individual
Prefix:DR
First Name:JESSY
Middle Name:JOYKUTTY
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JESSY
Other - Middle Name:
Other - Last Name:JOYKUTTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:205 EASTON AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-4410
Mailing Address - Country:US
Mailing Address - Phone:732-253-4402
Mailing Address - Fax:732-427-8186
Practice Address - Street 1:205 EASTON AVE STE 2
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-4410
Practice Address - Country:US
Practice Address - Phone:732-253-4402
Practice Address - Fax:732-427-8186
Is Sole Proprietor?:No
Enumeration Date:2009-06-28
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09161500207Q00000X
PAMT194624P207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine