Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 25MA11032600 | NJ |
NPI | 1407112246 |
---|---|
Provider Name | Shannon A Tomita |
First Address | Boston, MA 02241-6457 |
Second Address | Morristown, NJ 07960-6136 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2012 |
Last Update Date | 22/07/2021 |