Provider Demographics
NPI:1568628022
Name:CORNELIUS TOMA MD PC
Entity type:Organization
Organization Name:CORNELIUS TOMA MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CORNELIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-586-9666
Mailing Address - Street 1:8 QUAKERBRIDGE PLZ
Mailing Address - Street 2:
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1255
Mailing Address - Country:US
Mailing Address - Phone:609-586-9666
Mailing Address - Fax:609-586-9666
Practice Address - Street 1:8 QUAKERBRIDGE PLZ
Practice Address - Street 2:
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619-1255
Practice Address - Country:US
Practice Address - Phone:609-586-9666
Practice Address - Fax:609-586-9666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03041600261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care