Individual
TIM TOMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
355 PRAIRIE AVE, PROVIDENCE, RI 02905-1928
(401) 444-0570
(401) 444-0427
Mailing address
375 ALLENS AVE, PROVIDENCE, RI 02905-5010
(401) 444-0400
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD20666
RI
390200000X
Student in an Organized Health Care Education/Training Program
4351049386
MI
Other
Enumeration date
07/22/2022
Last updated
07/02/2025
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