MEDICARE: DR. DANIEL P TREMENTOZZI M.D.01/08/1967

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	0101231223	VA

General Provider Information

NPI Number	:	1821060047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL P TREMENTOZZI M.D.01/08/1967

Provider Business Mailing Address
First Line	:	PO BOX 216
Second Line	:
City	:	LADYSMITH
State	:	VA
Zip	:	22501-0216
Country	:	US
Telephone Number	:	804-448-1380
Fax Number	:	804-448-9571

Provider Business Practice Location Address
First Line	:	18048 JEFFERSON DAVIS HWY
Second Line	:
City	:	RUTHER GLEN
State	:	VA
Zip	:	22546-2922
Country	:	US
Telephone Number	:	804-448-1380
Fax Number	:	804-448-9571

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

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	03/31/2011

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