1124029566 NPI number — DR. PATRICIA TOMSKO NAY M.D.

Table of content: DR. KENNETH KUN PHARM.D (NPI 1639588726)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124029566 NPI number — DR. PATRICIA TOMSKO NAY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAY
Provider First Name:
PATRICIA
Provider Middle Name:
TOMSKO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TOMSKO
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1124029566
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/12/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21324 BEALLSVILLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DICKERSON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20842-9064
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-294-1864
Provider Business Mailing Address Fax Number:
301-349-5177

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11140 ROCKVILLE PIKE
Provider Second Line Business Practice Location Address:
#348
Provider Business Practice Location Address City Name:
ROCKVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20852-3106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-294-1864
Provider Business Practice Location Address Fax Number:
301-349-5177
Provider Enumeration Date:
08/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207QG0300X , with the licence number:  D0051916 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: G00023 . This is a "MEDICARE GROUP NUMBER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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