Provider Demographics
NPI:1316902497
Name:PORRAZZO, THOMAS GRIFFEN (PHD, ATC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:GRIFFEN
Last Name:PORRAZZO
Suffix:
Gender:M
Credentials:PHD, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 CANDY RD
Mailing Address - Street 2:
Mailing Address - City:MOHNTON
Mailing Address - State:PA
Mailing Address - Zip Code:19540-8322
Mailing Address - Country:US
Mailing Address - Phone:610-775-3956
Mailing Address - Fax:
Practice Address - Street 1:400 SAINT BERNARDINE ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19607-1737
Practice Address - Country:US
Practice Address - Phone:610-796-8311
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer