Provider Demographics
NPI:1194542191
Name:SHEILS, THOMAS P
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:P
Last Name:SHEILS
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 1:28 RUTH ELLEN RD
Mailing Address - Street 2:
Mailing Address - City:HOLLISTON
Mailing Address - State:MA
Mailing Address - Zip Code:01746-1216
Mailing Address - Country:US
Mailing Address - Phone:617-901-7837
Mailing Address - Fax:
Practice Address - Street 1:777 BROCKTON AVE
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:MA
Practice Address - Zip Code:02351-2111
Practice Address - Country:US
Practice Address - Phone:781-857-2291
Practice Address - Fax:781-857-2916
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADOP6255156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician