Provider Demographics
NPI:1154314805
Name:FASHOUER, THOMAS F (ATC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:F
Last Name:FASHOUER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 EXECUTIVE PARK DR
Mailing Address - Street 2:ALBANY PHYSICAL THERAPY
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-3718
Mailing Address - Country:US
Mailing Address - Phone:518-489-2449
Mailing Address - Fax:518-489-2991
Practice Address - Street 1:4 EXECUTIVE PARK DR
Practice Address - Street 2:ALBANY PHYSICAL THERAPY
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-3718
Practice Address - Country:US
Practice Address - Phone:518-489-2449
Practice Address - Fax:518-489-2991
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0000602255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer