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JUSTIN THAI THACH PA
NPI 1558558395
Physician Assistant - Surgical in College Point, NY

Active since September 25, 2007
1217 119TH ST, COLLEGE POINT, NY 11356(646) 898-7446 Get Directions Write a Review

NPPES record last updated: December 9, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Justin Thai Thach Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUSTIN THAI THACH PA (NPI 1558558395) is an individual surgical provider in College Point, New York, licensed in New York (012085) and active in the NPI registry since September 2007.

NPPES Registry Identity

NPI1558558395
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameJUSTIN THAI THACHCredential: PA
Location Address1217 119TH STCollege Point, NY 11356-1648
Mailing Address1217 119th StCollege Point, NY 11356-1648 · (646) 898-7446
Phone(646) 898-7446
Sole ProprietorYes
Enumeration DateSeptember 25, 2007
Last NPPES UpdateDecember 9, 2015
✔ NPI 1558558395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in NY · 012085
1217 119TH ST, College Point, NY 11356
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justin Thach's NPI number?

The NPI number for Justin Thach is 1558558395. It was assigned to this individual provider in the NPPES registry on September 25, 2007.

Where is Justin Thach located?

Justin Thach practices at 1217 119th St, College Point, NY 11356. The listed phone number is (646) 898-7446.

What is Justin Thach's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Justin Thach was last updated on December 9, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.