Provider Demographics
NPI:1710340815
Name:TOHA, ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:TOHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7220 NIGHTINGALE DR APT 2
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-8396
Mailing Address - Country:US
Mailing Address - Phone:954-383-4776
Mailing Address - Fax:
Practice Address - Street 1:WINSTON BUILDING
Practice Address - Street 2:1000 TENTH AVENUE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1001
Practice Address - Country:US
Practice Address - Phone:212-523-6915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY303231207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY303231Medicaid