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Individual

DR. TOM A TASSAKIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1550 E CHESTNUT AVE, BUILDING 4 SUITE D, VINELAND, NJ 08361
(856) 691-1910
(856) 691-8330
Mailing address
PO BOX 62, SWEDESBORO, NJ 08085-0062
(856) 467-0390
(856) 467-9747

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
25MA06255100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
663940200
NJ
01
P00613557
RAILROAD MEDICARE
NJ
Enumeration date
10/05/2006
Last updated
09/18/2008
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