Healthcare Provider Details

I. General information

NPI: 1497861462
Provider Name (Legal Business Name): PAMELA C. TOLA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2089 KLOCKNER RD
HAMILTON NJ
08690-3416
US

IV. Provider business mailing address

2089 KLOCKNER RD
HAMILTON NJ
08690-3416
US

V. Phone/Fax

Practice location:
  • Phone: 609-588-5474
  • Fax: 609-588-4949
Mailing address:
  • Phone: 609-588-5474
  • Fax: 609-588-4949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number25MD00210400
License Number StateNJ

VIII. Authorized Official

Name: DR. PAMELA C. TOLA
Title or Position: OWNER/PODIATRIST
Credential: D.P.M.
Phone: 609-588-5474