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General NPI Number Information
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NPI Number | 1437208089
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Entity Type | Individual
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Provider Name | JAMES TOMASELLI N.Y.S.L.O, ABOC
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Gender | Male
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 130 E PARK AVE
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City | LONG BEACH
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State | NY
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Zip | 11561-3510
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Country | US
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Telephone | 151-667-0060
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Fax |
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Provider Business Mailing Address
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Address Line | 7009 68TH PL
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City | GLENDALE
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State | NY
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Zip | 11385-6618
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Country | US
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Telephone | 134-722-3408
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 0008493
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License Number State | NY
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