Provider Demographics
NPI:1215144886
Name:THOMAS M MCGUIGAN
Entity type:Organization
Organization Name:THOMAS M MCGUIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCGUIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:609-883-1605
Mailing Address - Street 1:1076 PARKWAY AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-3002
Mailing Address - Country:US
Mailing Address - Phone:609-883-1605
Mailing Address - Fax:609-883-6160
Practice Address - Street 1:1076 PARKWAY AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08628-3002
Practice Address - Country:US
Practice Address - Phone:609-883-1605
Practice Address - Fax:609-883-6160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MO00091800213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1323202Medicaid
NJ0767090001Medicare NSC
NJ451250Medicare ID - Type Unspecified