Provider Demographics
NPI:1811054778
Name:PLAHOVINSAK, THOMAS JOHN (PHD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOHN
Last Name:PLAHOVINSAK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 LAKEHURST RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6344
Mailing Address - Country:US
Mailing Address - Phone:732-240-1617
Mailing Address - Fax:732-341-0757
Practice Address - Street 1:448 LAKEHURST RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6344
Practice Address - Country:US
Practice Address - Phone:732-240-1617
Practice Address - Fax:732-341-0757
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2796103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ024100UNAMedicare PIN