Provider Demographics
NPI:1508038183
Name:THOMAS, DANIEL J (PT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:THOMAS
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 1:576 BROADHOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-5002
Mailing Address - Country:US
Mailing Address - Phone:631-359-5859
Mailing Address - Fax:
Practice Address - Street 1:64 PORTSMOUTH AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:STRATHAM
Practice Address - State:NH
Practice Address - Zip Code:03885-6552
Practice Address - Country:US
Practice Address - Phone:603-772-8222
Practice Address - Fax:603-772-6738
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2041225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist