MEDICARE: KATHY TOBIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	167309	NY

General Provider Information

NPI Number	:	1447245998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY TOBIN MD

Provider Business Mailing Address
First Line	:	150 E 69TH ST APT 12R
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-5722
Country	:	US
Telephone Number	:	952-595-1301
Fax Number	:	612-294-4903

Provider Business Practice Location Address
First Line	:	1650 SELWYN AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10457-7626
Country	:	US
Telephone Number	:	952-595-1100
Fax Number	:	612-294-4903

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	08/16/2013

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