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General NPI Number Information
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NPI Number | 1871590323
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Entity Type | Individual
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Provider Name | WILLIAM J TOMASULO R.PH.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5115 BEACH CHANNEL DR
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-1042
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Country | US
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Telephone | 718-734-2647
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Fax |
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Provider Business Mailing Address
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Address Line | 903 HELEN CT
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City | NORTH BELLMORE
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State | NY
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Zip | 11710-1029
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Country | US
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Telephone | 516-221-4533
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 027987
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License Number State | NY
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