Provider Demographics
NPI:1417163346
Name:HANSHAW, THOMAS L (MED)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:L
Last Name:HANSHAW
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 CAROL ST
Mailing Address - Street 2:
Mailing Address - City:NEW CUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17070-1215
Mailing Address - Country:US
Mailing Address - Phone:717-774-5482
Mailing Address - Fax:
Practice Address - Street 1:510 CAROL ST
Practice Address - Street 2:
Practice Address - City:NEW CUMBERLAND
Practice Address - State:PA
Practice Address - Zip Code:17070-1215
Practice Address - Country:US
Practice Address - Phone:717-774-5482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS000793L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist