Healthcare Provider Details

I. General information

NPI: 1669465100
Provider Name (Legal Business Name): RICHARD FRANK TONZOLA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 E MAIN ST
ROCKAWAY NJ
07866-3530
US

IV. Provider business mailing address

170 E MAIN ST
ROCKAWAY NJ
07866-3530
US

V. Phone/Fax

Practice location:
  • Phone: 973-625-8888
  • Fax: 973-625-7877
Mailing address:
  • Phone: 973-625-8888
  • Fax: 973-625-7877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA02929400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: