Provider Demographics
NPI:1467636316
Name:OATS, THOMAS ALBERT (PT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ALBERT
Last Name:OATS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 GREENWAY WEST
Mailing Address - Street 2:
Mailing Address - City:ORIENT
Mailing Address - State:NY
Mailing Address - Zip Code:11957-1325
Mailing Address - Country:US
Mailing Address - Phone:631-470-1730
Mailing Address - Fax:
Practice Address - Street 1:805 GREENWAY WEST
Practice Address - Street 2:
Practice Address - City:ORIENT
Practice Address - State:NY
Practice Address - Zip Code:11957-1325
Practice Address - Country:US
Practice Address - Phone:631-470-1730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015069-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQH5831Medicare PIN