Provider Demographics
NPI:1538259718
Name:TOMMASINO, JOSEPH FAIELLA (RPA-C PHD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FAIELLA
Last Name:TOMMASINO
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Gender:M
Credentials:RPA-C PHD
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Mailing Address - Street 1:14 MONTICELLO DR
Mailing Address - Street 2:
Mailing Address - City:SHOREHAM
Mailing Address - State:NY
Mailing Address - Zip Code:11786-2047
Mailing Address - Country:US
Mailing Address - Phone:631-846-1396
Mailing Address - Fax:631-846-1396
Practice Address - Street 1:206 FALLWOOD PKWY
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-4929
Practice Address - Country:US
Practice Address - Phone:516-249-1020
Practice Address - Fax:516-249-1305
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2009-07-28
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Provider Licenses
StateLicense IDTaxonomies
NY002330-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical