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General NPI Number Information
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NPI Number | 1649465642
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Entity Type | Individual
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Provider Name | THOMAS M OBROTKA MD
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Gender | Male
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 09/12/2007
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Provider Practice Location Address
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Address Line | 516 HAMBERG TNPK STE 10 N JERSEY MED VLG
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City | WAYNE
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State | NJ
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Zip | 07470
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Country | US
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Telephone | 973-904-0271
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Fax | 970-904-1330
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Provider Business Mailing Address
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Address Line | 516 HAMBERG TNPK STE 10 N JERSEY MED VLG
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City | WAYNE
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State | NJ
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Zip | 07470
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Country | US
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Telephone | 973-904-0271
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Fax | 970-904-1330
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MA029742
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License Number State | NJ
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