Provider Demographics
NPI:1306005699
Name:ANTHONY TOMASSO, DO PLLC
Entity Type:Organization
Organization Name:ANTHONY TOMASSO, DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMASSO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-281-8670
Mailing Address - Street 1:2 CORACI BLVD
Mailing Address - Street 2:STE #4
Mailing Address - City:SHIRLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11967-4833
Mailing Address - Country:US
Mailing Address - Phone:631-281-8670
Mailing Address - Fax:631-281-8242
Practice Address - Street 1:2 CORACI BLVD
Practice Address - Street 2:STE #4
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-4833
Practice Address - Country:US
Practice Address - Phone:631-281-8670
Practice Address - Fax:631-281-8242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185350207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty