Provider Demographics
NPI:1053673178
Name:AMBIENT
Entity Type:Organization
Organization Name:AMBIENT
Other - Org Name:AMBIENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:TOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:TOBLER
Authorized Official - Suffix:
Authorized Official - Credentials:TVI
Authorized Official - Phone:917-292-1271
Mailing Address - Street 1:1329 SAWKILL RD
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-7901
Mailing Address - Country:US
Mailing Address - Phone:917-292-1271
Mailing Address - Fax:
Practice Address - Street 1:1329 SAWKILL RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401
Practice Address - Country:US
Practice Address - Phone:917-292-1271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty