Healthcare Provider Details

I. General information

NPI: 1407169394
Provider Name (Legal Business Name): TOBIE SEYLER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 07/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5467 UPPER MOUNTAIN RD SUITE 200
LOCKPORT NY
14094-1854
US

IV. Provider business mailing address

1669 LAKE RD
YOUNGSTOWN NY
14174-9724
US

V. Phone/Fax

Practice location:
  • Phone: 716-439-7400
  • Fax: 716-439-7521
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number578578-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: