Provider Demographics
NPI:1831671379
Name:TOBIN, MERCEDES Q (APN, RN, AGCNS-BC)
Entity Type:Individual
Prefix:MRS
First Name:MERCEDES
Middle Name:Q
Last Name:TOBIN
Suffix:
Gender:F
Credentials:APN, RN, AGCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:INTERNAL MED ASSOC
Mailing Address - Street 2:201 LAUREL HEIGHTS DRIVE
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-6265
Mailing Address - Country:US
Mailing Address - Phone:856-455-4800
Mailing Address - Fax:856-451-0650
Practice Address - Street 1:201 LAUREL HEIGHTS DR UPPR
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-3635
Practice Address - Country:US
Practice Address - Phone:856-455-4800
Practice Address - Fax:856-453-1450
Is Sole Proprietor?:No
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00818400364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health