Provider Demographics
NPI:1487614657
Name:ZWART, THOMAS PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PAUL
Last Name:ZWART
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 149
Mailing Address - Street 2:
Mailing Address - City:PINE BUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12566
Mailing Address - Country:US
Mailing Address - Phone:845-744-2420
Mailing Address - Fax:845-744-2429
Practice Address - Street 1:103 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:PINE BUSH
Practice Address - State:NY
Practice Address - Zip Code:12566-7120
Practice Address - Country:US
Practice Address - Phone:845-744-2420
Practice Address - Fax:845-744-2429
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX06006-3111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician