Provider Demographics
NPI:1275838500
Name:THEODORE J TOGLIATTI & CO INC
Entity Type:Organization
Organization Name:THEODORE J TOGLIATTI & CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:J
Authorized Official - Last Name:TOGLIATTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-589-8819
Mailing Address - Street 1:339 CLINE AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1072
Mailing Address - Country:US
Mailing Address - Phone:419-589-8819
Mailing Address - Fax:419-589-8892
Practice Address - Street 1:339 CLINE AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1072
Practice Address - Country:US
Practice Address - Phone:419-589-8819
Practice Address - Fax:419-589-8892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35085417208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3130605Medicaid