Provider Demographics
NPI:1679004022
Name:TOMASKOVIC, STEPHEN
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:TOMASKOVIC
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 1:601 HAMBURG TPKE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2048
Mailing Address - Country:US
Mailing Address - Phone:862-257-1370
Mailing Address - Fax:
Practice Address - Street 1:601 HAMBURG TPKE
Practice Address - Street 2:SUITE 104
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2048
Practice Address - Country:US
Practice Address - Phone:862-257-1370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MG00124900237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist