Basic Information
Provider Information
NPI: 1962791517
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PFEIFFER
FirstName: THOMAS
MiddleName: R
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 5520
Address2:  
City: BETHLEHEM
State: PA
PostalCode: 180150520
CountryCode: US
TelephoneNumber: 6109545810
FaxNumber:  
Practice Location
Address1: 801 OSTRUM ST
Address2:  
City: BETHLEHEM
State: PA
PostalCode: 180151000
CountryCode: US
TelephoneNumber: 6109545810
FaxNumber: 6109545480
Other Information
ProviderEnumerationDate: 04/05/2011
LastUpdateDate: 01/07/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/07/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XMD456585PAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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