Provider Demographics
NPI:1710015854
Name:BAROUK, THOMAS N
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:N
Last Name:BAROUK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:PAXTON
Mailing Address - State:MA
Mailing Address - Zip Code:01612
Mailing Address - Country:US
Mailing Address - Phone:508-868-5831
Mailing Address - Fax:508-798-3497
Practice Address - Street 1:340 MAIN ST
Practice Address - Street 2:SUITE 503 CEDAR ST FAMLIY CLINIC
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608
Practice Address - Country:US
Practice Address - Phone:508-926-0070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health