Healthcare Provider Details

I. General information

NPI: 1477679173
Provider Name (Legal Business Name): TOSHIKO KOBAYASHI MA, ATR-BC, LCAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 04/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 W END AVE SUITE 18L
NEW YORK NY
10023-5601
US

IV. Provider business mailing address

160 W END AVE SUITE 18L
NEW YORK NY
10023-5601
US

V. Phone/Fax

Practice location:
  • Phone: 917-517-6649
  • Fax:
Mailing address:
  • Phone: 917-517-6649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number000139-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: