Provider Demographics
NPI:1801472063
Name:TOMS RIVER ADDICTION MEDICINE
Entity type:Organization
Organization Name:TOMS RIVER ADDICTION MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:COMERCI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-310-1264
Mailing Address - Street 1:318 FARWOOD RD
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:737-221-5682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Single Specialty