Provider Demographics
NPI:1215179486
Name:TOLLIN, CRAIG J (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:J
Last Name:TOLLIN
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 HOLLAND PL
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-2503
Mailing Address - Country:US
Mailing Address - Phone:914-831-9220
Mailing Address - Fax:
Practice Address - Street 1:740 W END AVE
Practice Address - Street 2:SUITE #3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6246
Practice Address - Country:US
Practice Address - Phone:212-665-5119
Practice Address - Fax:212-666-3913
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008191-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist