=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306892781
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DONALD C TOMASELLO MD LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/26/2006
-----------------------------------------------------
Last Update Date | 10/29/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 VILLAGE DR
-----------------------------------------------------
City | CAPE MAY COURT HOUSE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08210-1939
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-463-8600
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 56
-----------------------------------------------------
City | CAPE MAY COURT HOUSE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08210-0056
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. DONALD C TOMASELLO
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 609-463-8600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 25MA07424400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------