Provider Demographics
NPI:1821567124
Name:THOMAS, CHRIS MATHEW (PT, DPT)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:MATHEW
Last Name:THOMAS
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 BROAD ST STE 250
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3066
Mailing Address - Country:US
Mailing Address - Phone:877-532-7837
Mailing Address - Fax:
Practice Address - Street 1:1455 BROAD ST STE 250
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3066
Practice Address - Country:US
Practice Address - Phone:877-532-7837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01798700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist