Provider Demographics
NPI:1073805149
Name:TIO, VINCENT W (DO)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:W
Last Name:TIO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:VINCE
Other - Middle Name:
Other - Last Name:TIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:1 DIAMOND HILL RD
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-2104
Mailing Address - Country:US
Mailing Address - Phone:908-273-4300
Mailing Address - Fax:
Practice Address - Street 1:282 E RTE 4
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5101
Practice Address - Country:US
Practice Address - Phone:551-222-0800
Practice Address - Fax:551-222-0801
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA71443207PE0004X
PAOS018281207P00000X
NJ25MB09781100207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services