Provider Demographics
NPI:1821325002
Name:DOELL-CARBONE, TOBY M (RN)
Entity Type:Individual
Prefix:MRS
First Name:TOBY
Middle Name:M
Last Name:DOELL-CARBONE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 KNOLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-9142
Mailing Address - Country:US
Mailing Address - Phone:585-388-7681
Mailing Address - Fax:
Practice Address - Street 1:73 KNOLLWOOD DR
Practice Address - Street 2:
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-9142
Practice Address - Country:US
Practice Address - Phone:585-388-7681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY554305-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse