Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | D0051916 | MD |
NPI | 1124029566 |
---|---|
Provider Name | Dr. Patricia Tomsko Nay |
First Address | Dickerson, MD 20842-9064 |
Second Address | Rockville, MD 20852-3106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 12/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G00023 | MEDICARE GROUP NUMBER (01) | MD |
G65669 | (02) |