Provider Demographics
NPI:1881402808
Name:TOMAINO, RYAN JAMES (PA-C)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:JAMES
Last Name:TOMAINO
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5839 HARBOUR VIEW BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3797
Mailing Address - Country:US
Mailing Address - Phone:757-483-6100
Mailing Address - Fax:
Practice Address - Street 1:5839 HARBOUR VIEW BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3797
Practice Address - Country:US
Practice Address - Phone:757-483-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110011046363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant