Provider Demographics
NPI:1306251830
Name:DIPAOLO, THOMAS VINCENT (DPT)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:VINCENT
Last Name:DIPAOLO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 TERRILL RD STE B
Mailing Address - Street 2:
Mailing Address - City:FANWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07023-1018
Mailing Address - Country:US
Mailing Address - Phone:908-288-7503
Mailing Address - Fax:908-288-7420
Practice Address - Street 1:193 TERRILL RD STE B
Practice Address - Street 2:
Practice Address - City:FANWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07023-1018
Practice Address - Country:US
Practice Address - Phone:908-288-7503
Practice Address - Fax:908-288-7420
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01553800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist