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General NPI Number Information
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NPI Number | 1568467058
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Entity Type | Individual
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Provider Name | JOHN G TUMILLO JR. MD
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Gender | Male
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 1 HAMILTON HEALTH PL
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City | HAMILTON
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State | NJ
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Zip | 08690-3542
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Country | US
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Telephone | 609-586-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 16 N 9TH ST
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City | SURF CITY
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State | NJ
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Zip | 08008-5337
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Country | US
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Telephone | 609-709-5158
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 25MA06529600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MA06529600
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License Number State | NJ
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