Provider Demographics
NPI:1578885877
Name:TOBOLSKI, JAMES A
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:A
Last Name:TOBOLSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 BUFFALO ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-3862
Mailing Address - Country:US
Mailing Address - Phone:716-648-2990
Mailing Address - Fax:
Practice Address - Street 1:358 BUFFALO ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-3862
Practice Address - Country:US
Practice Address - Phone:716-648-2990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-28
Last Update Date:2010-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038233183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist