1255330890 NPI number — DR. BARBARA C TOMMASULO M.D.

Table of content: DR. BARBARA C TOMMASULO M.D. (NPI 1255330890)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255330890 NPI number — DR. BARBARA C TOMMASULO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOMMASULO
Provider First Name:
BARBARA
Provider Middle Name:
C
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:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255330890
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/12/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
900 FRANKLIN AVE
Provider Second Line Business Mailing Address:
ORZAC CENTER FOR EXTENDED CARE AND REHABILITATION
Provider Business Mailing Address City Name:
VALLEY STREAM
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11580-2145
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-256-6551
Provider Business Mailing Address Fax Number:
516-256-6143

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 FRANKLIN AVE
Provider Second Line Business Practice Location Address:
ORZAC CENTER FOR EXTENDED CARE AND REHABILITATION
Provider Business Practice Location Address City Name:
VALLEY STREAM
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11580-2145
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-256-6551
Provider Business Practice Location Address Fax Number:
516-256-6143
Provider Enumeration Date:
07/16/2005

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: 207RG0300X , with the licence number:  173288 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01403983 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 16F031 . This is a "PROVIDER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 173288 . This is a "HIP OF NEW YORK-HEALTH PL" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com