Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Thomas R. Gustafson, MD

Individual provider Family Medicine Physician · NPI 1720055528

Dr. Thomas R. Gustafson, MD is a Family Medicine Physician in Pine City, New York. Licensed in New York and Pennsylvania. Registered with an NPI since 2006.

Licensed in
NY, PA
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1243 Pennsylvania Ave
Pine City, NY 14871-9230
Phone: (607) 734-3929
Fax: (607) 734-0781
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 186217-1 (NY)
Family Medicine Physician Taxonomy 207Q00000X · Licence MD042588L (PA)

Record details

NPI number1720055528
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 1, 2006
Last updated in NPPESJuly 29, 2011

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