Provider Demographics
NPI:1821130774
Name:NAGY, THOMAS F (PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:F
Last Name:NAGY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 MIDDLEFIELD RD STE 212B
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2124
Mailing Address - Country:US
Mailing Address - Phone:650-324-1854
Mailing Address - Fax:650-324-1873
Practice Address - Street 1:555 MIDDLEFIELD RD STE 212B
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2124
Practice Address - Country:US
Practice Address - Phone:650-324-1854
Practice Address - Fax:650-324-1873
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10981103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY109810Medicaid
CAPSY109810Medicaid
CAS66909Medicare UPIN