Healthcare Provider Details

I. General information

NPI: 1396090296
Provider Name (Legal Business Name): CHRISTOPHER TOHER SPECIALIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2012
Last Update Date: 07/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 S MANNING BLVD
ALBANY NY
12208-1708
US

IV. Provider business mailing address

314 S MANNING BLVD
ALBANY NY
12208-1708
US

V. Phone/Fax

Practice location:
  • Phone: 518-437-5717
  • Fax: 518-437-5551
Mailing address:
  • Phone: 518-437-5717
  • Fax: 518-437-5551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: