Provider Demographics
NPI:1447294962
Name:PRICE, THOMAS FRANCIS SR (PT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:FRANCIS
Last Name:PRICE
Suffix:SR
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 1:8 GARDENIA CT
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-4500
Mailing Address - Country:US
Mailing Address - Phone:856-262-8577
Mailing Address - Fax:856-346-3375
Practice Address - Street 1:215 E LAUREL RD
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1361
Practice Address - Country:US
Practice Address - Phone:856-262-8577
Practice Address - Fax:856-346-3375
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2008-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00354600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ650020404OtherRAILROAD MEDICARE
NJ650020404OtherRAILROAD MEDICARE