Provider Demographics
NPI:1508257395
Name:TOMA, KATHERINE (DO)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:TOMA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1541 ROUTE 88 W STE A
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-2373
Mailing Address - Country:US
Mailing Address - Phone:732-836-3200
Mailing Address - Fax:732-836-3201
Practice Address - Street 1:1541 ROUTE 88 W STE A
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-2373
Practice Address - Country:US
Practice Address - Phone:732-836-3200
Practice Address - Fax:732-836-3201
Is Sole Proprietor?:No
Enumeration Date:2015-02-14
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302729207RN0300X, 207R00000X
NJ25MB11029200207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1508257395Medicaid