Provider Demographics
NPI:1689688863
Name:TOMCZAK, JENNIFER MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARIE
Last Name:TOMCZAK
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:990 STEWART AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4822
Mailing Address - Country:US
Mailing Address - Phone:516-222-2022
Mailing Address - Fax:516-222-8475
Practice Address - Street 1:990 STEWART AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4822
Practice Address - Country:US
Practice Address - Phone:516-222-2022
Practice Address - Fax:516-222-8475
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2022-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY242385-12085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology