Healthcare Provider Details

I. General information

NPI: 1336899871
Provider Name (Legal Business Name): NATALIYA TOIB FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2022
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 LAKESIDE PARK
SOUTHAMPTON PA
18966-4049
US

IV. Provider business mailing address

PO BOX 62939
BALTIMORE MD
21264-4049
US

V. Phone/Fax

Practice location:
  • Phone: 215-322-1058
  • Fax:
Mailing address:
  • Phone: 859-291-4800
  • Fax: 833-694-1507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberSP025071
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP025071
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: