Provider Demographics
NPI:1801007273
Name:TOMKOVICH, SHARON (RN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:TOMKOVICH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COLBY AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084-1000
Mailing Address - Country:US
Mailing Address - Phone:856-541-1700
Mailing Address - Fax:856-346-3627
Practice Address - Street 1:1 COLBY AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1000
Practice Address - Country:US
Practice Address - Phone:856-541-1700
Practice Address - Fax:856-346-3627
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2024-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26N004381500163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26N004381500OtherNURSING LICENSE