Provider Demographics
NPI:1720094881
Name:KINGSLEY, THOMAS A (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:A
Last Name:KINGSLEY
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3752 ROUTE 9G
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1173
Mailing Address - Country:US
Mailing Address - Phone:845-876-8220
Mailing Address - Fax:845-876-8221
Practice Address - Street 1:3752 ROUTE 9G
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1173
Practice Address - Country:US
Practice Address - Phone:845-876-8220
Practice Address - Fax:845-876-8221
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015726-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYKI0Q0WSI10OtherMEDICARE GROUP EDI#
NY810921OtherACN GROUP PROVIDER ID
NY1003832692OtherGROUP NPI#
NY9386153OtherPHCS PROVIDER ID
NYQL686Q0SI1OtherMEDICARE T.KINGSLEY PAPER
NY2042030OtherUNITED HEALTHCARE PROV ID
NY2984871OtherAETNA PROVIDER ID
NYTK0QL68620OtherMEDICARE T.KINGSLEY EDI#
NY55418OtherGHI-HMO PROVIDER ID
NY437294OtherMVP PROVIDER ID
NYP2791617OtherOXFORD PROVIDER ID
NY55418OtherGHI-HMO PROVIDER ID
NYQL6862Medicare ID - Type UnspecifiedPROVIDER NUMBER