Provider Demographics
NPI:1568479855
Name:STONE, THOMAS JOSEPH (DPT, ATC, OCS, CSCS)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JOSEPH
Last Name:STONE
Suffix:
Gender:M
Credentials:DPT, ATC, OCS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1774 WESTON AVE
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-3735
Mailing Address - Country:US
Mailing Address - Phone:410-274-0045
Mailing Address - Fax:
Practice Address - Street 1:3401 BOSTON ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4981
Practice Address - Country:US
Practice Address - Phone:410-522-2177
Practice Address - Fax:410-522-2178
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD211642251S0007X, 225100000X, 2251X0800X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2125267OtherMAMSI
MD80705OtherGREAT WEST 1 HEALTH PLAN
MD47610152OtherBCBS/DC
MD68241OtherPRUDENTIAL
MD7416479OtherCIGNA
MD33752OtherIWIF
MD641253-01OtherBCBS/MD
MD2125267OtherMAMSI