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NPI Code Detail

MEDICARE: DR. THOMAS DEPAOLA M.D.

MEDICARE: DR. THOMAS DEPAOLA M.D.
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
1208000000XPediatrics Physician050898CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2050898OTHERCTSTATE LICENSE

General Provider Information

NPI Number : 1225098452
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS DEPAOLA M.D.
Provider Business Mailing Address
First Line : 2570 ROUTE 9W
Second Line : SUITE 10
City : CORNWALL
State : NY
Zip : 12518-1323
Country : US
Telephone Number : 845-220-3100
Fax Number : 845-534-2940
Provider Business Practice Location Address
First Line : 147 LAKE ST
Second Line :
City : NEWBURGH
State : NY
Zip : 12550-5263
Country : US
Telephone Number : 845-563-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 03/07/2023

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