Provider Demographics
NPI:1407951965
Name:TOMASZEWSKI, ROBERT J
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:TOMASZEWSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21053 DEVONSHIRE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-2364
Mailing Address - Country:US
Mailing Address - Phone:818-886-7222
Mailing Address - Fax:818-886-7223
Practice Address - Street 1:21053 DEVONSHIRE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-2364
Practice Address - Country:US
Practice Address - Phone:818-886-7222
Practice Address - Fax:818-886-7223
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7837103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAR30950Medicare UPIN