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General NPI Number Information
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NPI Number | 1093933327
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Entity Type | Individual
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Provider Name | CARMELYN D. TOBIN P.T.
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Gender | Female
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 799 BLOOMFIELD AVE
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City | VERONA
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State | NJ
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Zip | 07044-1367
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Country | US
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Telephone | 973-259-3585
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Fax | 973-239-3096
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Provider Business Mailing Address
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Address Line | 89 GORDONHURST AVE
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City | MONTCLAIR
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State | NJ
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Zip | 07043-1715
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Country | US
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Telephone | 973-744-1861
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA00441400
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License Number State | NJ
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