Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | OS007618L | PA |
N | 111NI0900X | Internist | OS007618L | PA |
Y | 207RA0401X | Internist - Addiction Medicine | OS007618L | PA |
NPI | 1003809450 |
---|---|
Provider Name | Lisa A Tomsak |
First Address | Delray Beach, FL 33483-5211 |
Second Address | Delray Beach, FL 33483-5211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 28/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0013931090006 | (05) | PA |
F44476 | (02) |