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NPI Code Detail

MEDICARE: DR. ANTHONY TOMASSO D.O.

MEDICARE:  DR. ANTHONY  TOMASSO  D.O.
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
1207Q00000XFamily Medicine Physician1853501NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962408708
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTHONY TOMASSO D.O.
Provider Business Mailing Address
First Line : 2 CORACI BLVD
Second Line : STE 4
City : SHIRLEY
State : NY
Zip : 11967-4833
Country : US
Telephone Number : 631-281-8670
Fax Number :
Provider Business Practice Location Address
First Line : 2 CORACI BLVD
Second Line : STE 4
City : SHIRLEY
State : NY
Zip : 11967-4833
Country : US
Telephone Number : 631-281-8670
Fax Number : 631-281-8242
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 07/09/2007

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Directions to “ DR. ANTHONY TOMASSO D.O.” Practice Location

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