Provider Demographics
NPI:1164600672
Name:TOBIN, TERESA CATHERINE (RN)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:CATHERINE
Last Name:TOBIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 CHURCHILL RD
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-1708
Mailing Address - Country:US
Mailing Address - Phone:617-230-9412
Mailing Address - Fax:617-471-1670
Practice Address - Street 1:940 BELMONT ST
Practice Address - Street 2:(118)
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301
Practice Address - Country:US
Practice Address - Phone:617-230-9412
Practice Address - Fax:617-471-1670
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA279206163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse