Provider Demographics
NPI:1508960196
Name:ULRICH, TOMAS F (DC)
Entity Type:Individual
Prefix:MR
First Name:TOMAS
Middle Name:F
Last Name:ULRICH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:558 LAWRENCE SQUARE BLVD S
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2674
Mailing Address - Country:US
Mailing Address - Phone:609-585-6100
Mailing Address - Fax:609-581-2103
Practice Address - Street 1:558 LAWRENCE SQUARE BLVD S
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2674
Practice Address - Country:US
Practice Address - Phone:609-585-6100
Practice Address - Fax:609-581-2103
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00305300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ078591R50Medicare ID - Type Unspecified
U99674Medicare UPIN