Provider Demographics
NPI:1073708020
Name:THOMAS F. DEBLASIO
Entity Type:Organization
Organization Name:THOMAS F. DEBLASIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:DEBLASIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-866-6600
Mailing Address - Street 1:200 CRAIG RD
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8735
Mailing Address - Country:US
Mailing Address - Phone:732-866-6600
Mailing Address - Fax:732-866-6611
Practice Address - Street 1:200 CRAIG RD
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8735
Practice Address - Country:US
Practice Address - Phone:732-866-6600
Practice Address - Fax:732-866-6611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05815100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
7236855A1Medicare PIN
NJF28003Medicare UPIN