Provider Demographics
NPI:1336769389
Name:ROONEY, THOMAS JACOB
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JACOB
Last Name:ROONEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 1/2 SANBORN TER
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-1617
Mailing Address - Country:US
Mailing Address - Phone:617-407-4963
Mailing Address - Fax:
Practice Address - Street 1:333 BORTHWICK AVE STE 100
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4198
Practice Address - Country:US
Practice Address - Phone:617-407-4963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine