Provider Demographics
NPI:1942356761
Name:HEGENS, THOMAS (CSA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:HEGENS
Suffix:
Gender:M
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8116 ARLINGTON BLVD STE 117
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1002
Mailing Address - Country:US
Mailing Address - Phone:202-491-7688
Mailing Address - Fax:
Practice Address - Street 1:8116 ARLINGTON BLVD STE 117
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1002
Practice Address - Country:US
Practice Address - Phone:202-491-7688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2906246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCSA0017OtherDEPT OF HEALTH, HEALTH PROFESSIONAL LICENSING ADMINISTRATION