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NPI Code Detail

MEDICARE: THOMAS J LACLAIR MD

MEDICARE:   THOMAS J LACLAIR  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician138252NY

General Provider Information

NPI Number : 1003819053
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS J LACLAIR MD
Provider Business Mailing Address
First Line : 1001 W FAYETTE ST
Second Line : STE 400
City : SYRACUSE
State : NY
Zip : 13204-2866
Country : US
Telephone Number : 315-472-1488
Fax Number : 315-472-8060
Provider Business Practice Location Address
First Line : 436 HINSDALE RD
Second Line :
City : CAMILLUS
State : NY
Zip : 13031-1648
Country : US
Telephone Number : 315-488-0996
Fax Number : 315-488-1955
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 05/12/2008

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Directions to “ THOMAS J LACLAIR MD” Practice Location

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