Provider Demographics
NPI:1417084575
Name:WRIGHT, THOMAS CARR JR (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:CARR
Last Name:WRIGHT
Suffix:JR
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:PO BOX 291
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:10533-0291
Mailing Address - Country:US
Mailing Address - Phone:212-203-3961
Mailing Address - Fax:
Practice Address - Street 1:84 STATION RD
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NY
Practice Address - Zip Code:10533-2134
Practice Address - Country:US
Practice Address - Phone:212-203-3961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174667-1207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D38073Medicare UPIN
NY27E621Medicare ID - Type Unspecified