Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 25MA06901100 | NJ |
NPI | 1508830746 |
---|---|
Provider Name | Daniel Tobias |
First Address | Boston, MA 02241-6457 |
Second Address | Morristown, NJ 07960-6136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 10/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
31578U77 | MEDICARE ID - TYPE UNSPECIFIED (01) | NJ |
H04500 | (02) | NJ |