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General NPI Number Information
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NPI Number | 1841562014
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Entity Type | Individual
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Provider Name | ROLANDO LLULL TOMBO MD
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Gender | Male
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 08/31/2012
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Provider Practice Location Address
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Address Line | 1945 ROUTE 33
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City | NEPTUNE
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State | NJ
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Zip | 07753-4859
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Country | US
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Telephone | 732-776-4420
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Fax |
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Provider Business Mailing Address
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Address Line | 1502 GARDEN DR APT 7
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City | OCEAN
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State | NJ
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Zip | 07712-7610
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Country | US
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Telephone | 732-492-9983
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA09143800
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License Number State | NJ
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