Provider Demographics
NPI:1831498310
Name:ARNOLD C TOBACK MD PC
Entity Type:Organization
Organization Name:ARNOLD C TOBACK MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:TOBACK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-737-1440
Mailing Address - Street 1:2 E 69TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4906
Mailing Address - Country:US
Mailing Address - Phone:212-737-1440
Mailing Address - Fax:212-535-0573
Practice Address - Street 1:2 E 69TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4906
Practice Address - Country:US
Practice Address - Phone:212-737-1440
Practice Address - Fax:212-535-0573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155647207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA63874Medicare UPIN