Basic Information
| Provider Information | |||||||||
| NPI: | 1700931029 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOMASSO | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | J. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8 CEDARLAWN RD | ||||||||
| Address2: | |||||||||
| City: | IRVINGTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105331903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9145916713 | ||||||||
| FaxNumber: | 9145918470 | ||||||||
| Practice Location | |||||||||
| Address1: | 34 S BROADWAY STE 600 | ||||||||
| Address2: | |||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106014428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146819435 | ||||||||
| FaxNumber: | 9142319148 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2007 | ||||||||
| LastUpdateDate: | 11/17/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 011279 | NY | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 01541491 | 05 | NY | MEDICAID |