Provider Demographics
NPI:1083834733
Name:THOMAS, MARGARET (PT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3224
Mailing Address - Country:US
Mailing Address - Phone:203-498-5980
Mailing Address - Fax:203-498-5999
Practice Address - Street 1:230 GEORGE ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3224
Practice Address - Country:US
Practice Address - Phone:203-498-5980
Practice Address - Fax:203-498-5999
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070015663225100000X
CT9064225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT9064OtherSTATE THERAPIST LICENSE