Provider Demographics
NPI:1356649644
Name:TOBIN, SHAWN PATRICK (MA RD LDN)
Entity Type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:PATRICK
Last Name:TOBIN
Suffix:
Gender:M
Credentials:MA RD LDN
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Mailing Address - Street 1:34TH STREET AND CIVIC CENTER BLVD
Mailing Address - Street 2:CHILDREN'S HOSPITAL OF PHILADELPHIA CSH RM 102
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-0000
Mailing Address - Country:US
Mailing Address - Phone:267-426-8784
Mailing Address - Fax:
Practice Address - Street 1:34TH STREET AND CIVIC CENTER BLVD
Practice Address - Street 2:CHILDREN'S HOSPITAL OF PHILADELPHIA CSH RM 102
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-0000
Practice Address - Country:US
Practice Address - Phone:267-426-8784
Practice Address - Fax:215-590-9338
Is Sole Proprietor?:No
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
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Provider Licenses
StateLicense IDTaxonomies
PADN002257133V00000X, 133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered