Provider Demographics
NPI:1285680496
Name:FUCHS, THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:FUCHS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 51ST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2908
Mailing Address - Country:US
Mailing Address - Phone:718-854-0420
Mailing Address - Fax:
Practice Address - Street 1:1153 58TH ST
Practice Address - Street 2:BORO PARK PRIMARY MEDICAL PLLC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-4526
Practice Address - Country:US
Practice Address - Phone:718-431-9870
Practice Address - Fax:718-484-0236
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY151975-1207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01642199Medicaid
NYP00652021Medicare PIN
F65038Medicare UPIN