Provider Demographics
NPI:1518088343
Name:HOANG, THOMAS (RPH,CDM,LICAC,MAC,)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:HOANG
Suffix:
Gender:M
Credentials:RPH,CDM,LICAC,MAC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 PRATTS JUNCTION RD
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:MA
Mailing Address - Zip Code:01564-2300
Mailing Address - Country:US
Mailing Address - Phone:978-235-5059
Mailing Address - Fax:
Practice Address - Street 1:1031 MAIN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MA
Practice Address - Zip Code:01510-1134
Practice Address - Country:US
Practice Address - Phone:978-368-8540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA202983171100000X
MA22803183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered183500000XPharmacy Service ProvidersPharmacist