Provider Demographics
NPI:1629366398
Name:RANK, THOMAS S (APRN)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:S
Last Name:RANK
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:20 YORK ST CB-2041
Mailing Address - Street 2:NORTHEAST MEDICAL GROUP, INC.
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510
Mailing Address - Country:US
Mailing Address - Phone:203-688-4748
Mailing Address - Fax:203-688-4740
Practice Address - Street 1:20 YORK ST CB-2041
Practice Address - Street 2:NORTHEAST MEDICAL GROUP, INC.
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510
Practice Address - Country:US
Practice Address - Phone:203-688-4748
Practice Address - Fax:203-688-4740
Is Sole Proprietor?:No
Enumeration Date:2011-07-15
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT004680363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner