National Provider Identifier
Thomas William Jackson Mspt, PT
Thomas William Jackson Mspt, PT is listed in the NPPES registry with a primary specialty of Physical Therapist in Newark, NY and a listed phone number of (315) 332-2289.
Profile Overview
- NPI
- 1326682618
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- October 30, 2019
- Last Updated
- December 07, 2021
Practice Location
- 1200 Driving Park Ave
- Newark, NY 14513-1090
Phone: (315) 332-2289
Mailing Address
- PO Box 111
- Newark, NY 14513-0111
Specialties
- Physical Therapist (225100000X)
Endpoints
- tom.jackson@rochesterregional.org
Connect Url | Direct | Csv | Newark, NY 14513
- tom.jackson@rochesterregional.org
Connect Url | Health Information Exchange (Hie) | Csv | Newark, NY 14513
Full Record
- NPI
- 1326682618
- Entity Type
- Individual
- Last Name
- Jackson Mspt
- First Name
- Thomas
- Middle Name
- William
- Name Prefix
- Mr.
- Credential
- PT
- Mailing Street Address
- PO Box 111
- Mailing City
- Newark
- Mailing State
- NY
- Mailing ZIP Code
- 14513-0111
- Mailing Country
- US
- Mailing Phone
- (315) 332-2289
- Practice Street Address
- 1200 Driving Park Ave
- Practice City
- Newark
- Practice State
- NY
- Practice ZIP Code
- 14513-1090
- Practice Country
- US
- Practice Phone
- (315) 332-2289
- Enumeration Date
- October 30, 2019
- Last Updated
- December 07, 2021
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- December 07, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X)