Provider Demographics
NPI:1235169475
Name:THOMAS F SCADOVA PLLC
Entity Type:Organization
Organization Name:THOMAS F SCADOVA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:SCADOVA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:603-882-4221
Mailing Address - Street 1:451 AMHERST ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-1200
Mailing Address - Country:US
Mailing Address - Phone:603-882-4221
Mailing Address - Fax:603-886-5105
Practice Address - Street 1:451 AMHERST ST
Practice Address - Street 2:SUITE 101
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-1200
Practice Address - Country:US
Practice Address - Phone:603-882-4221
Practice Address - Fax:603-886-5105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH0406152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
52330OtherCIGNA
NH30354109Medicaid
0902285Y00H02OtherANTHEM BCBS
0902285Y00H02OtherANTHEM BCBS