Provider Demographics
NPI:1366146664
Name:TOME, PAUL JORGE JR (PA-C)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:JORGE
Last Name:TOME
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:
Practice Address - Street 1:2309 E EVESHAM RD STE 201A
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1559
Practice Address - Country:US
Practice Address - Phone:856-325-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2024-08-07
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00743100363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant