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General NPI Number Information
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NPI Number | 1649627027
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Entity Type | Individual
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Provider Name | TOBIN ANSEL O.D.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2016
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Last Update Date | 03/22/2021
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Provider Practice Location Address
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Address Line | 2090 STATE ROUTE 27 STE 105
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-1142
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Country | US
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Telephone | 732-658-6765
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Fax |
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Provider Business Mailing Address
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Address Line | 38 DWIGHT AVE
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City | HILLSDALE
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State | NJ
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Zip | 07642-1656
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Country | US
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Telephone | 201-723-9851
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2994
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00673100
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License Number State | NJ
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