| Tara M. Tomasso, M.d., L.l.c. | |
|
612 Glassboro Rd Woodbury Heights NJ 08097-1423 | |
| (856) 845-0323 | |
| (856) 845-4322 |
| Full Name | Tara M. Tomasso, M.d., L.l.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 612 Glassboro Rd, Woodbury Heights, New Jersey |
| Authorized Official Name and Position | Tara M Tomasso (OWNER) |
| Authorized Official Contact | 8568450323 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tara M. Tomasso, M.d., L.l.c. 612 Glassboro Rd Woodbury Heights NJ 08097-1423 Ph: (856) 845-0323 | Tara M. Tomasso, M.d., L.l.c. 612 Glassboro Rd Woodbury Heights NJ 08097-1423 Ph: (856) 845-0323 |
| NPI Number | 1659574713 |
|---|---|
| Provider Enumeration Date | 06/07/2007 |
| Last Update Date | 03/31/2021 |
| Medicare PECOS PAC ID | 9032202155 |
|---|---|
| Medicare Enrollment ID | O20070906000230 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659574713 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MA-71527 (New Jersey) | Primary |
| Provider Name | Tara M Tomasso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225122401 PECOS PAC ID: 7416914239 Enrollment ID: I20041214000314 |
Innovative Physical Therapy And Wellness Of Nj Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1006 Mantua Pike, Woodbury Heights, NJ 08097 Phone: 443-512-8337 Fax: 443-327-5282 |