Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 165959 | NY |
NPI | 1053506220 |
---|---|
Provider Name | Dr. Dan Richard Tobin |
First Address | Altamont, NY 12009-5705 |
Second Address | Albany, NY 12208-3410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2007 |
Last Update Date | 11/09/2007 |