1841268810 NPI number — THOMAS GERMANO MD

Table of content: THOMAS GERMANO MD (NPI 1841268810)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841268810 NPI number — THOMAS GERMANO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GERMANO
Provider First Name:
THOMAS
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1841268810
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9484
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PROVIDENCE
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02940-9484
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-854-2500
Provider Business Mailing Address Fax Number:
401-854-2501

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
593 EDDY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PROVIDENCE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02903-4923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-519-1604
Provider Business Practice Location Address Fax Number:
401-272-0538
Provider Enumeration Date:
03/08/2006

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: 207P00000X , with the licence number:  MD10530 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3086101 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02/01/2006 . This is a "BCBS" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 10/12/2006 . This is a "NHPRI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 007058230 . This is a "RI MEDICARE (UEMF)" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 04/15/2009 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 03/24/2009 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: TG21617 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".




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