Provider Demographics
NPI:1780843714
Name:TOMAINO, JULI (MD)
Entity Type:Individual
Prefix:DR
First Name:JULI
Middle Name:
Last Name:TOMAINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1352 C ST SE UNIT A
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2391
Mailing Address - Country:US
Mailing Address - Phone:718-514-0528
Mailing Address - Fax:
Practice Address - Street 1:1352 C ST SE UNIT A
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2391
Practice Address - Country:US
Practice Address - Phone:718-514-0528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248357174400000X
IL0361284972080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL206147OtherMEDICARE PTAN (GROUP)
IL206147078OtherMEDICARE PTAN (INDIVIDUAL)
IL036128497Medicaid