Provider Demographics
NPI:1619048311
Name:SAMLUK, THOMAS F (CRNP)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:F
Last Name:SAMLUK
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 BEECH DRIVE
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-5421
Mailing Address - Country:US
Mailing Address - Phone:610-279-6100
Mailing Address - Fax:610-279-0928
Practice Address - Street 1:50 BEECH DRIVE
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-5421
Practice Address - Country:US
Practice Address - Phone:610-279-6100
Practice Address - Fax:610-279-0928
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP0081362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA076882KKDMedicare ID - Type Unspecified