Provider Demographics
NPI:1891791778
Name:PRESTEL, THOMAS F (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:F
Last Name:PRESTEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2100 KEYSTONE AVE
Mailing Address - Street 2:STE 309
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-1127
Mailing Address - Country:US
Mailing Address - Phone:610-394-9860
Mailing Address - Fax:610-394-9922
Practice Address - Street 1:2100 KEYSTONE AVE
Practice Address - Street 2:STE 309
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-1127
Practice Address - Country:US
Practice Address - Phone:610-394-9860
Practice Address - Fax:610-394-9922
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD023565E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0715905Medicaid
PA157569Medicare ID - Type Unspecified
PAC32236Medicare UPIN