Provider Demographics
NPI:1922434869
Name:TOMASZEWSKI, DONALD (ATC/L)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:
Last Name:TOMASZEWSKI
Suffix:
Gender:M
Credentials:ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 N VAN DIEN AVE
Mailing Address - Street 2:SPORTS INSTITUTE
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-2726
Mailing Address - Country:US
Mailing Address - Phone:201-447-8133
Mailing Address - Fax:201-251-3253
Practice Address - Street 1:223 N VAN DIEN AVE
Practice Address - Street 2:SPORTS INSTITUTE
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-2726
Practice Address - Country:US
Practice Address - Phone:201-447-8133
Practice Address - Fax:201-251-3253
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT000310002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MT00031000OtherNJ BOARD OF MEDICAL EXAMINERS