MEDICARE: MR. VINCENT STO TOMAS PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	025256	NY

General Provider Information

NPI Number	:	1841407103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VINCENT STO TOMAS PT, DPT

Provider Business Mailing Address
First Line	:	38 DEERFIELD ST
Second Line	:
City	:	BERGENFIELD
State	:	NJ
Zip	:	07621-1805
Country	:	US
Telephone Number	:	718-839-3046
Fax Number	:

Provider Business Practice Location Address
First Line	:	1537 WASHINGTON AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10457-8308
Country	:	US
Telephone Number	:	718-583-2913
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	04/08/2020

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