Provider Demographics
NPI:1619942802
Name:WOO, THOMA H (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMA
Middle Name:H
Last Name:WOO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5388
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-0388
Mailing Address - Country:US
Mailing Address - Phone:908-735-4477
Mailing Address - Fax:908-735-6532
Practice Address - Street 1:1 DOGWOOD DR
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:NJ
Practice Address - Zip Code:08801-3101
Practice Address - Country:US
Practice Address - Phone:908-735-4477
Practice Address - Fax:908-735-6532
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA078874002085R0202X
NJ25MA0788874002085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0074535Medicaid
NJH98344Medicare UPIN
NJ0074535Medicaid