Provider Demographics
NPI:1134208986
Name:LAUDINO, THOMAS ALLAN (PT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ALLAN
Last Name:LAUDINO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 PLAZA CT, C
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301
Mailing Address - Country:US
Mailing Address - Phone:570-421-7020
Mailing Address - Fax:570-421-7091
Practice Address - Street 1:600 PLAZA CT, C
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301
Practice Address - Country:US
Practice Address - Phone:570-421-7020
Practice Address - Fax:570-421-7091
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME11521161OtherCAQH UNIVERSAL CREDENTIAL
MEPT2973OtherLICENSE#
ME099104OtherANTHEM S
ME11521161OtherCAQH UNIVERSAL CREDENTIAL