MEDICARE: MRS. THERESE K TOMASOSKI 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	208000000X	Pediatrics Physician	5385	AK

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	:	1184639775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. THERESE K TOMASOSKI MD

Provider Business Mailing Address
First Line	:	3760 PIPER ST
Second Line	:	SUITE 1060
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-4665
Country	:	US
Telephone Number	:	907-212-6522
Fax Number	:	907-212-6593

Provider Business Practice Location Address
First Line	:	2250 SOUTH WOODWORTH LOOP
Second Line	:	SUITE 101
City	:	PALMER
State	:	AK
Zip	:	99645-7457
Country	:	US
Telephone Number	:	907-761-5900
Fax Number	:	907-761-5999

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

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	02/11/2013

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