Basic Information
| Provider Information | |||||||||
| NPI: | 1639311681 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TONGCO | ||||||||
| FirstName: | CESAREO AMADEO | ||||||||
| MiddleName: | URBANO | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | II | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1884 BUENA VISTA DR | ||||||||
| Address2: | |||||||||
| City: | COSHOCTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 438123007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405024662 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 440 BROWNS LN | ||||||||
| Address2: | |||||||||
| City: | COSHOCTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 438122044 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7406220332 | ||||||||
| FaxNumber: | 7406220335 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2009 | ||||||||
| LastUpdateDate: | 02/14/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QS0010X | 4301093075 | MI | N | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | 207Q00000X | 35096724 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.