Provider Demographics
NPI:1942202965
Name:TOMCYKOSKI, PAUL ANTHONY (DO,FAACP)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ANTHONY
Last Name:TOMCYKOSKI
Suffix:
Gender:M
Credentials:DO,FAACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:516 N BLAKELY ST
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-1935
Mailing Address - Country:US
Mailing Address - Phone:570-344-7388
Mailing Address - Fax:570-344-7323
Practice Address - Street 1:516 N BLAKELY ST
Practice Address - Street 2:
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512-1935
Practice Address - Country:US
Practice Address - Phone:570-344-7388
Practice Address - Fax:570-344-7323
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-009027-L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOS-009027-LOtherSTATE LICENSE
PAOS-009027-LOtherSTATE LICENSE