Provider Demographics
NPI:1639325483
Name:TOMAR, RUSSELL HERMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:HERMAN
Last Name:TOMAR
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 1:185 SOUTH ORANGE AVENUE
Mailing Address - Street 2:UH C107
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-2714
Mailing Address - Country:US
Mailing Address - Phone:973-972-4086
Mailing Address - Fax:
Practice Address - Street 1:185 SOUTH ORANGE AVENUE
Practice Address - Street 2:VH C107
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2714
Practice Address - Country:US
Practice Address - Phone:973-972-4086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08450200207K00000X, 207ZC0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology