Provider Demographics
NPI:1356311641
Name:TOBEY CHIROPRACTIC WELLNESS,P.C.
Entity Type:Organization
Organization Name:TOBEY CHIROPRACTIC WELLNESS,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:W
Authorized Official - Last Name:TOBEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-782-5770
Mailing Address - Street 1:18 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-3504
Mailing Address - Country:US
Mailing Address - Phone:845-782-5770
Mailing Address - Fax:845-782-9061
Practice Address - Street 1:18 LAKE ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-3504
Practice Address - Country:US
Practice Address - Phone:845-782-5770
Practice Address - Fax:845-782-9061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWX4321Medicare PIN