Healthcare Provider Details

I. General information

NPI: 1013620525
Provider Name (Legal Business Name): DR TOLA TSARUMI MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2022
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 WASHINGTON ST STE 360
WELLESLEY MA
02481-6204
US

IV. Provider business mailing address

332 WASHINGTON ST STE 360
WELLESLEY MA
02481-6204
US

V. Phone/Fax

Practice location:
  • Phone: 617-668-1239
  • Fax:
Mailing address:
  • Phone: 617-668-1239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: OMOTOLA TSARUMI
Title or Position: OWNER
Credential: MD
Phone: 917-870-1596