Provider Demographics
NPI:1669465100
Name:TONZOLA, RICHARD FRANK (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:FRANK
Last Name:TONZOLA
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 1:170 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-3530
Mailing Address - Country:US
Mailing Address - Phone:973-625-8888
Mailing Address - Fax:973-625-7877
Practice Address - Street 1:170 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-3530
Practice Address - Country:US
Practice Address - Phone:973-625-8888
Practice Address - Fax:973-625-7877
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA029294002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
450146AZCMedicare ID - Type Unspecified
C58554Medicare UPIN