DR. THOMAS R. GUSTAFSON MD
NPI 1720055528
Family Medicine in Pine City, NY

Active since March 01, 2006
1243 PENNSYLVANIA AVE, PINE CITY, NY 14871(607) 734-3929(607) 734-0781 Get Directions Write a Review

NPPES record last updated: July 29, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Thomas R. Gustafson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THOMAS R. GUSTAFSON MD (NPI 1720055528) is an individual family medicine provider in Pine City, New York, licensed in New York (186217-1) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1720055528
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. THOMAS R. GUSTAFSONCredential: MD
Location Address1243 PENNSYLVANIA AVEPine City, NY 14871-9230
Mailing Address1 Guthrie SqSayre, PA 18840-1625 · (570) 888-5858
Fax(607) 734-0781
Sole ProprietorNo
Enumeration DateMarch 1, 2006
Last NPPES UpdateJuly 29, 2011
NPI 1720055528 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses Licensed in NY · 186217-1 Licensed in PA · MD042588L
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1243 PENNSYLVANIA AVE, Pine City, NY 14871

Other Identifiers 6

Medicare ID-Type Unspecified51425JNY
OtherCC8362NY · Rr Medicare Group
Medicaid0012479510001PA
Medicare UPINE89748
Other080173355NY · Rr Medicare Pin
Medicaid01255774NY

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Multi-Specialty)
1243 PENNSYLVANIA AVE
PINE CITY, NY 14871
Internal Medicine (Cardiovascular Disease)
1243 PENNSYLVANIA AVE
PINE CITY, NY 14871
Family Medicine
1243 PENNSYLVANIA AVE
PINE CITY, NY 14871
Family Medicine
1243 PENNSYLVANIA AVE
PINE CITY, NY 14871
Family Medicine
1243 PENNSYLVANIA AVE
PINE CITY, NY 14871
Physician Assistant
1243 PENNSYLVANIA AVE
PINE CITY, NY 14871
Durable Medical Equipment & Medical Supplies
1243 PENNSYLVANIA AVE
PINE CITY, NY 14871
Internal Medicine (Cardiovascular Disease)
1243 PENNSYLVANIA AVE
PINE CITY, NY 14871

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thomas Gustafson's NPI number?

The NPI number for Thomas Gustafson is 1720055528. It was assigned to this individual provider in the NPPES registry on March 1, 2006.

Where is Thomas Gustafson located?

Thomas Gustafson practices at 1243 Pennsylvania Ave, Pine City, NY 14871. The listed phone number is (607) 734-3929.

What is Thomas Gustafson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Thomas Gustafson was last updated on July 29, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.