Provider Demographics
NPI:1417072802
Name:NEILANS, THOMAS H (PHD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:H
Last Name:NEILANS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LINDEN OAKS
Mailing Address - Street 2:STE 200
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2840
Mailing Address - Country:US
Mailing Address - Phone:585-586-1600
Mailing Address - Fax:585-586-7951
Practice Address - Street 1:100 LINDEN OAKS
Practice Address - Street 2:STE 200
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2840
Practice Address - Country:US
Practice Address - Phone:585-586-1600
Practice Address - Fax:585-586-7951
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008258103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical