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NPI Code Detail

MEDICARE: TOBY TYBERG MS

MEDICARE: TOBY TYBERG MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst001772NY
2174400000XSpecialistNY

General Provider Information

NPI Number : 1710341045
Entity Type Code : Individual
Provider Name (Legal Business Name) : TOBY TYBERG MS
Provider Business Mailing Address
First Line : 1312 38TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11218-3612
Country : US
Telephone Number : 718-686-3700
Fax Number :
Provider Business Practice Location Address
First Line : 1312 38TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11218-3612
Country : US
Telephone Number : 718-686-3700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2016
Last Update Date : 03/09/2026

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