1720094881 NPI number — MR. THOMAS A KINGSLEY PHYSICAL THERAPIST

Table of content: MR. THOMAS A KINGSLEY PHYSICAL THERAPIST (NPI 1720094881)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720094881 NPI number — MR. THOMAS A KINGSLEY PHYSICAL THERAPIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KINGSLEY
Provider First Name:
THOMAS
Provider Middle Name:
A
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PHYSICAL THERAPIST
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:
1720094881
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/02/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3752 ROUTE 9G
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RHINEBECK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12572-1173
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-876-8220
Provider Business Mailing Address Fax Number:
845-876-8221

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3752 ROUTE 9G
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RHINEBECK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12572-1173
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-876-8220
Provider Business Practice Location Address Fax Number:
845-876-8221
Provider Enumeration Date:
07/31/2006

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: 225100000X , with the licence number:  015726-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: KI0Q0WSI10 . This is a "MEDICARE GROUP EDI#" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 810921 . This is a "ACN GROUP PROVIDER ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1003832692 . This is a "GROUP NPI#" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 9386153 . This is a "PHCS PROVIDER ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: QL686Q0SI1 . This is a "MEDICARE T.KINGSLEY PAPER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2042030 . This is a "UNITED HEALTHCARE PROV ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2984871 . This is a "AETNA PROVIDER ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: TK0QL68620 . This is a "MEDICARE T.KINGSLEY EDI#" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 55418 . This is a "GHI-HMO PROVIDER ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 437294 . This is a "MVP PROVIDER ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P2791617 . This is a "OXFORD PROVIDER ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com