MEDICARE: EVANGELIA TSOMOS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	25MA06713200	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134178122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVANGELIA TSOMOS MD

Provider Business Mailing Address
First Line	:	PO BOX 1173
Second Line	:	VALLEY EMERGENCY ROOM ASSOCIATES PA
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07451
Country	:	US
Telephone Number	:	800-777-2455
Fax Number	:	610-617-6280

Provider Business Practice Location Address
First Line	:	1 DIAMOND HILL RD
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-2104
Country	:	US
Telephone Number	:	908-277-8950
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	03/04/2026

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