Healthcare Provider Details

I. General information

NPI: 1194982744
Provider Name (Legal Business Name): REEM J TOMA AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 10/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16777 MEDICAL CENTER DR PLAZA 2ND FLOOR AUDIOLOGY
BATON ROUGE LA
70816-3254
US

IV. Provider business mailing address

16777 MEDICAL CENTER DR PLAZA 2ND FLOOR AUDIOLOGY
BATON ROUGE LA
70816-3254
US

V. Phone/Fax

Practice location:
  • Phone: 225-754-5089
  • Fax:
Mailing address:
  • Phone: 225-754-5089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number4763
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number4763
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: