Provider Demographics
NPI:1952541096
Name:TOMARO, ANGELA S (OT)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:S
Last Name:TOMARO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1386 BLUE FACTORY HILL RD
Mailing Address - Street 2:
Mailing Address - City:CROPSEYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12052-3017
Mailing Address - Country:US
Mailing Address - Phone:518-421-5172
Mailing Address - Fax:
Practice Address - Street 1:1386 BLUE FACTORY HILL RD
Practice Address - Street 2:
Practice Address - City:CROPSEYVILLE
Practice Address - State:NY
Practice Address - Zip Code:12052-3017
Practice Address - Country:US
Practice Address - Phone:518-421-5172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006243-1174400000X
NY017198225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No174400000XOther Service ProvidersSpecialist