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General NPI Number Information
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NPI Number | 1760406342
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Entity Type | Organization
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Legal Business Name | THOMAS M. OBROTKA MD
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Dates
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Enumeration Date | 07/27/2006
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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 HAMBURG TPKE N JERSEY MEDICAL VILLAGE STE 10
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City | WAYNE
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State | NJ
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Zip | 07470-2062
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Country | US
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Telephone | 973-904-0271
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Fax | 973-904-1330
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Provider Business Mailing Address
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Address Line | 516 HAMBURG TPKE N JERSEY MEDICAL VILLAGE STE 10
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City | WAYNE
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State | NJ
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Zip | 07470-2062
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Country | US
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Telephone | 973-904-0271
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Fax | 973-904-1330
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. THOMAS MATTHEW OBROTKA
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Credential | MD
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Telephone | 973-904-0271
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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 |
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License Number State |
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