Provider Demographics
NPI:1255806089
Name:LAUBSCHER, THOMAS LOUIS (RD, LDN)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:LOUIS
Last Name:LAUBSCHER
Suffix:
Gender:M
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9430 LISA LN
Mailing Address - Street 2:
Mailing Address - City:BREINIGSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18031-1132
Mailing Address - Country:US
Mailing Address - Phone:610-841-1818
Mailing Address - Fax:
Practice Address - Street 1:5300 KIDSPEACE DR
Practice Address - Street 2:
Practice Address - City:OREFIELD
Practice Address - State:PA
Practice Address - Zip Code:18069-2044
Practice Address - Country:US
Practice Address - Phone:610-799-8546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN000204133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013039916OtherCMS