Healthcare Provider Details

I. General information

NPI: 1750624656
Provider Name (Legal Business Name): THOMAS CHARLES PITTS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2013
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 BROADWAY FL 2
NEW YORK NY
10007-2056
US

IV. Provider business mailing address

3421 CONCORD RD
YORK PA
17402-9001
US

V. Phone/Fax

Practice location:
  • Phone: 646-596-7386
  • Fax: 646-360-2739
Mailing address:
  • Phone: 717-851-5503
  • Fax: 717-851-5507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2987-320
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4301115993
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD481156
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number289410
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: