Provider Demographics
NPI:1477789006
Name:DAMIANI, THOMAS NGUYEN (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:NGUYEN
Last Name:DAMIANI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 467 BOX 4564
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09096-1036
Mailing Address - Country:US
Mailing Address - Phone:011491511-426-4029
Mailing Address - Fax:
Practice Address - Street 1:UNIT 29623, BOX 0059
Practice Address - Street 2:WIESBADEN HEALTH CLINIC (ATTN: OPTOMETRY CLINIC)
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09096
Practice Address - Country:US
Practice Address - Phone:011491511-426-4029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006175152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist