Provider Demographics
NPI:1053530584
Name:DROGE, THOMAS (LAC, LMT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:DROGE
Suffix:
Gender:M
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 E 56TH ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2711
Mailing Address - Country:US
Mailing Address - Phone:212-223-1320
Mailing Address - Fax:212-223-9073
Practice Address - Street 1:141 E 56TH ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2711
Practice Address - Country:US
Practice Address - Phone:212-223-1320
Practice Address - Fax:212-223-9073
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1365171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP2734889OtherOXFORD PROVIDER #