Provider Demographics
NPI:1770581696
Name:COMERCI, THOMAS ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ROBERT
Last Name:COMERCI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:318 FARWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-4013
Mailing Address - Country:US
Mailing Address - Phone:908-310-1264
Mailing Address - Fax:737-221-5682
Practice Address - Street 1:250 WASHINGTON ST STE A6
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7575
Practice Address - Country:US
Practice Address - Phone:908-310-1264
Practice Address - Fax:734-342-6206
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2021-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD073255L207R00000X, 207RA0401X, 208M00000X
NJ25MA07265700207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0039365Medicaid