Healthcare Provider Details

I. General information

NPI: 1841619327
Provider Name (Legal Business Name): ALBERT THOMAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2014
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N QUINCY ST STE 601
ARLINGTON VA
22203-1729
US

IV. Provider business mailing address

801 N QUINCY ST STE 601
ARLINGTON VA
22203-1729
US

V. Phone/Fax

Practice location:
  • Phone: 703-812-4642
  • Fax:
Mailing address:
  • Phone: 703-812-4642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number0101272193
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number291420
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101272193
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: