Individual
DR. THOMAS PTAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-3850
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
D0083946
MD
2085R0202X
Diagnostic Radiology Physician
74590
MA
2085R0202X
Diagnostic Radiology Physician
D0083946
MD
2085R0202X
Diagnostic Radiology Physician
Primary
MD487489
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091658433
—
DC
05
—
889007200
—
MD
Enumeration date
12/05/2005
Last updated
01/27/2026
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