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General NPI Number Information
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NPI Number | 1306005699
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Entity Type | Organization
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Legal Business Name | ANTHONY TOMASSO, DO PLLC
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 2 CORACI BLVD STE #4
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City | SHIRLEY
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State | NY
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Zip | 11967-4833
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Country | US
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Telephone | 631-281-8670
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Fax | 631-281-8242
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Provider Business Mailing Address
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Address Line | 2 CORACI BLVD STE #4
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City | SHIRLEY
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State | NY
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Zip | 11967-4833
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Country | US
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Telephone | 631-281-8670
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Fax | 631-281-8242
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ANTHONY TOMASSO
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Credential | DO
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Telephone | 631-281-8670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 185350
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License Number State | NY
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