Provider Demographics
NPI:1255956421
Name:THOMSON, THOMAS LORBIE III (APRN)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:LORBIE
Last Name:THOMSON
Suffix:III
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-3821
Mailing Address - Country:US
Mailing Address - Phone:215-680-7323
Mailing Address - Fax:
Practice Address - Street 1:VA CONNECTICUT HEALTHCARE
Practice Address - Street 2:950 CAMPBELL AVENUE, MAIL CODE: 11ACSL1, BUILDING 2B
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516
Practice Address - Country:US
Practice Address - Phone:203-932-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8925363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology