Provider Demographics
NPI:1376810523
Name:TOMLINSON, CHIOMA NGUMEZI (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CHIOMA
Middle Name:NGUMEZI
Last Name:TOMLINSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ULUNMA
Other - Middle Name:CHIOMA
Other - Last Name:NGUMEZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:75 FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6110
Mailing Address - Country:US
Mailing Address - Phone:857-307-4100
Mailing Address - Fax:857-307-1366
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:857-307-4100
Practice Address - Fax:857-307-1366
Is Sole Proprietor?:No
Enumeration Date:2011-11-16
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA4249363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant