Provider Demographics
NPI:1386969707
Name:TOMULET, LIDIA (ND)
Entity type:Individual
Prefix:DR
First Name:LIDIA
Middle Name:
Last Name:TOMULET
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:LIDIA
Other - Middle Name:
Other - Last Name:MATASARU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:819 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4137
Mailing Address - Country:US
Mailing Address - Phone:919-641-3562
Mailing Address - Fax:888-688-8049
Practice Address - Street 1:819 BROAD ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4137
Practice Address - Country:US
Practice Address - Phone:919-641-3562
Practice Address - Fax:888-688-8049
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099.0064705175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath