Provider Demographics
NPI:1376696641
Name:TOBIAS, STEPHEN P (BC HIS)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:P
Last Name:TOBIAS
Suffix:
Gender:M
Credentials:BC HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-8115
Mailing Address - Country:US
Mailing Address - Phone:617-770-3395
Mailing Address - Fax:
Practice Address - Street 1:382 QUINCY AVE
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-8115
Practice Address - Country:US
Practice Address - Phone:617-770-3395
Practice Address - Fax:617-657-5163
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAHE 59-1237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist