Healthcare Provider Details

I. General information

NPI: 1306695242
Provider Name (Legal Business Name): MICHELLE TOBOROWSKY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2024
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 HIERING AVE APT 1
SEASIDE HEIGHTS NJ
08751-1755
US

IV. Provider business mailing address

14 STOWEBURY RD
WATERBURY CENTER VT
05677-7170
US

V. Phone/Fax

Practice location:
  • Phone: 723-908-9636
  • Fax:
Mailing address:
  • Phone: 732-908-9636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number26NR3680100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: