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NPI Code Detail

MEDICARE: MR. WILLIAM J TOMASULO R.PH.

MEDICARE: MR. WILLIAM J TOMASULO R.PH.
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
11835P1200XPharmacotherapy Pharmacist027987NY

General Provider Information

NPI Number : 1871590323
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM J TOMASULO R.PH.
Provider Business Mailing Address
First Line : 903 HELEN CT
Second Line :
City : NORTH BELLMORE
State : NY
Zip : 11710-1029
Country : US
Telephone Number : 516-221-4533
Fax Number :
Provider Business Practice Location Address
First Line : 5115 BEACH CHANNEL DR
Second Line :
City : FAR ROCKAWAY
State : NY
Zip : 11691-1042
Country : US
Telephone Number : 718-734-2647
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 07/08/2007

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