Provider Demographics
NPI:1467434175
Name:TOMOLONIS, RICHARD J (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:TOMOLONIS
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 1:87 MCGREGOR ST
Mailing Address - Street 2:SUITE 3100
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3731
Mailing Address - Country:US
Mailing Address - Phone:603-627-1887
Mailing Address - Fax:603-627-1890
Practice Address - Street 1:87 MCGREGOR ST
Practice Address - Street 2:SUITE 3100
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3731
Practice Address - Country:US
Practice Address - Phone:603-627-1887
Practice Address - Fax:603-627-1890
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13132208600000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH01Y010638NH01OtherANTHEM
NHAA62544OtherHARVARD PILGRIM
NHPENDINGMedicaid
NH2152393OtherUNITED HEALCARE
NHPENDINGMedicaid
NH01Y010638NH01OtherANTHEM