Provider Demographics
NPI:1427265032
Name:NAKAGAMA, TOMONORI (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:TOMONORI
Middle Name:
Last Name:NAKAGAMA
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 MADISON AVE RM 700
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-1166
Mailing Address - Country:US
Mailing Address - Phone:212-204-8567
Mailing Address - Fax:212-808-5510
Practice Address - Street 1:424 MADISON AVE RM 700
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1166
Practice Address - Country:US
Practice Address - Phone:212-204-8567
Practice Address - Fax:212-808-5510
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT557712083P0500X, 2083S0010X, 2083X0100X
NY2567042083S0010X, 2083P0500X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine