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General NPI Number Information
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NPI Number | 1174685986
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Entity Type | Individual
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Provider Name | NICHOLAS TOBIN C.N.P., P.C.N.S.
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Gender | Male
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 01/14/2022
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Provider Practice Location Address
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Address Line | 175 DWIGHT RD STE 103
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City | LONGMEADOW
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State | MA
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Zip | 01106-1767
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Country | US
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Telephone | 413-266-8326
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Fax | 413-317-7218
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Provider Business Mailing Address
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Address Line | 175 DWIGHT RD STE 103
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City | LONGMEADOW
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State | MA
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Zip | 01106-1767
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Country | US
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Telephone | 413-266-8326
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Fax | 413-317-7218
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 003515
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN252000
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License Number State | MA
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