Thomas Michael Nowakowski Jr., ATC
Individual provider Active NPI Athletic Trainer · Old Forge, PA
NPI 1669489407 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1669489407
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- RT003708 (PA)
- Practice address
- 501 South Main St
Old Forge, PA 18518 - Phone
- (570) 457-4099
- Fax
- (570) 457-7205
- NPI assigned
- Aug 2, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RT003708 | PA | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Therapy Associates of Northeast Pennsylvania Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | RT003708 | PA | Yes |
Addresses
Primary practice location
501 South Main St
Old Forge, PA 18518
Mailing address
915 Battle St
Scranton, PA 18508
Phone (570) 342-9906
Other providers in Old Forge, PA
- Dana Marie Montgomery
- NCHS, Inc.
- Nicole Dunbar Brush
- Noskco Inc
- Robert James Notari
- Old Forge Ambulance & Rescue Association
- Old Forge Chiropractic & Rehabilitation, P.C.
- Old Forge School District
- Old Forge Wellness LLC
- Sharon Palushock
All providers in Old Forge, PA · Athletic Trainer in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.