Provider Demographics
NPI:1053633354
Name:TRAINOR, THOMAS WALLACE (OTR/L)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:WALLACE
Last Name:TRAINOR
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 REGENT PL
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3914
Mailing Address - Country:US
Mailing Address - Phone:516-660-7430
Mailing Address - Fax:631-923-0758
Practice Address - Street 1:8 REGENT PL
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3914
Practice Address - Country:US
Practice Address - Phone:516-660-7430
Practice Address - Fax:631-923-0758
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-28
Last Update Date:2010-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015348-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist