Provider Demographics
NPI:1235156100
Name:NASCIMENTO, TOME Z (MD)
Entity Type:Individual
Prefix:DR
First Name:TOME
Middle Name:Z
Last Name:NASCIMENTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 CHRIS GAUPP DR
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-4460
Mailing Address - Country:US
Mailing Address - Phone:609-404-9900
Mailing Address - Fax:609-404-3653
Practice Address - Street 1:318 CHRIS GAUPP DR
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-4460
Practice Address - Country:US
Practice Address - Phone:609-404-9900
Practice Address - Fax:609-404-3653
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03389700207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP465268OtherOXFORD
NJ0076660000OtherAMERIHEALTH
NJ42938OtherAETNA
NJ4631333002OtherCIGNA
NJ4631333002OtherCIGNA
NJ42938OtherAETNA
NJ060039855Medicare PIN
NJ0076660000OtherAMERIHEALTH