Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | MA55750 | NJ |
NPI | 1053317701 |
---|---|
Provider Name | Dr. Vincent Anthony Tomasuolo JR. |
First Address | Jackson, NJ 08527-2267 |
Second Address | Toms River, NJ 08755-6432 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 01/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6530605 | (05) | NJ |
F32087 | (02) | NJ |