Provider Demographics
NPI:1912043589
Name:TOMIC, JEAN ANN (RNFA)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:ANN
Last Name:TOMIC
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ALAN DR
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-3301
Mailing Address - Country:US
Mailing Address - Phone:845-628-9112
Mailing Address - Fax:845-628-9112
Practice Address - Street 1:10 ALAN DR
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-3301
Practice Address - Country:US
Practice Address - Phone:845-628-9112
Practice Address - Fax:845-628-9112
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY417247-1163WR0006X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Not Answered282N00000XHospitalsGeneral Acute Care Hospital