1235146358 NPI number — THOMAS V NARO MSPT, DPT

Table of content: THOMAS V NARO MSPT, DPT (NPI 1235146358)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235146358 NPI number — THOMAS V NARO MSPT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NARO
Provider First Name:
THOMAS
Provider Middle Name:
V
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSPT, DPT
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:
1235146358
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/02/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
09/30/2021
NPI Reactivation Date:
07/13/2022

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
395 NH ROUTE 11
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARMINGTON
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03835-3844
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-839-1034
Provider Business Mailing Address Fax Number:
603-839-1039

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
35 GILLETTE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTHWICK
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01077-9461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-268-4230
Provider Business Practice Location Address Fax Number:
413-707-1409
Provider Enumeration Date:
08/02/2006

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: 2251X0800X , with the licence number:  3153 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251X0800X , with the licence number: 17621 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3079012 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30394605 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




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