1235681883 NPI number — KRISTINA TOBIN N.P.

Table of content: KRISTINA TOBIN N.P. (NPI 1235681883)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235681883 NPI number — KRISTINA TOBIN N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOBIN
Provider First Name:
KRISTINA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
N.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235681883
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
784 HERCULES DR
Provider Second Line Business Mailing Address:
STE 110
Provider Business Mailing Address City Name:
COLCHESTER
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05446-8049
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-210-5953
Provider Business Mailing Address Fax Number:
802-660-9438

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EXETER
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03833
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-772-9315
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/31/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP2300X , with the licence number:  073614-23 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LW0102X , with the licence number: 073614-2 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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