Provider Demographics
NPI:1437288776
Name:HALEY, THOMAS RAYMOND (DO)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:RAYMOND
Last Name:HALEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 HAGYS MILL RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-1750
Mailing Address - Country:US
Mailing Address - Phone:215-880-0000
Mailing Address - Fax:
Practice Address - Street 1:1603 E HIGH ST
Practice Address - Street 2:SUITE A
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-5061
Practice Address - Country:US
Practice Address - Phone:610-970-4700
Practice Address - Fax:610-970-5636
Is Sole Proprietor?:No
Enumeration Date:2007-03-04
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013059208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
I48227Medicare UPIN
PA097414MWAMedicare PIN