Provider Demographics
NPI:1336518216
Name:THOMSON, GILBERT HILAIRE (PT)
Entity Type:Individual
Prefix:MR
First Name:GILBERT
Middle Name:HILAIRE
Last Name:THOMSON
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 1:10 HELLBROOK LN
Mailing Address - Street 2:
Mailing Address - City:ULSTER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12487-5209
Mailing Address - Country:US
Mailing Address - Phone:845-658-7735
Mailing Address - Fax:845-658-7719
Practice Address - Street 1:2255 PLATTE CLOVE RD
Practice Address - Street 2:
Practice Address - City:ELKA PARK
Practice Address - State:NY
Practice Address - Zip Code:12427-1014
Practice Address - Country:US
Practice Address - Phone:518-589-5103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016216225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist