Provider Demographics
NPI:1891124236
Name:SACZYNSKI, THOMAS M (THOMAS SACZYNSKI, MS)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:M
Last Name:SACZYNSKI
Suffix:
Gender:M
Credentials:THOMAS SACZYNSKI, MS
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:M
Other - Last Name:SACZYNSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:THOMAS SACZYNSKI, MS
Mailing Address - Street 1:10974 RAMONA ST
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-9523
Mailing Address - Country:US
Mailing Address - Phone:909-800-0255
Mailing Address - Fax:
Practice Address - Street 1:10974 RAMONA ST
Practice Address - Street 2:
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-9523
Practice Address - Country:US
Practice Address - Phone:909-800-0255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program