Provider Demographics
NPI:1992006340
Name:THOMAS A MARGIUS, OD, PC
Entity Type:Organization
Organization Name:THOMAS A MARGIUS, OD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARGIUS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:203-877-4060
Mailing Address - Street 1:122 BROAD ST
Mailing Address - Street 2:WEST SUITE
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-4725
Mailing Address - Country:US
Mailing Address - Phone:203-877-4060
Mailing Address - Fax:203-877-1566
Practice Address - Street 1:122 BROAD ST
Practice Address - Street 2:WEST SUITE
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-4725
Practice Address - Country:US
Practice Address - Phone:203-877-4060
Practice Address - Fax:203-877-1566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001050152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004089901Medicaid
CTT22786Medicare UPIN
CTD100029444Medicare PIN
CT0343560002Medicare NSC