Provider Demographics
NPI:1871890848
Name:DIQUARTO, THOMAS PETER
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:PETER
Last Name:DIQUARTO
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 1:9801 CRYSTALLINE DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-7566
Mailing Address - Country:US
Mailing Address - Phone:775-379-4083
Mailing Address - Fax:
Practice Address - Street 1:9801 CRYSTALLINE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89506-7566
Practice Address - Country:US
Practice Address - Phone:775-379-4083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-27
Last Update Date:2011-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVGF-125403151Medicaid