Provider Demographics
NPI:1316105463
Name:LESCARBEAU, THOMAS DAVID (CFA)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:DAVID
Last Name:LESCARBEAU
Suffix:
Gender:M
Credentials:CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-2765
Mailing Address - Country:US
Mailing Address - Phone:413-664-6032
Mailing Address - Fax:
Practice Address - Street 1:15 HUDSON ST
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-2765
Practice Address - Country:US
Practice Address - Phone:413-664-6032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA95970246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant