Provider Demographics
NPI:1922060318
Name:TOBIN, LYNDA J (CRNP)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:J
Last Name:TOBIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LYNDA
Other - Middle Name:
Other - Last Name:MALMQUIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3624 MARKET STREET
Mailing Address - Street 2:SUITE 560 W
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2617
Mailing Address - Country:US
Mailing Address - Phone:215-662-3958
Mailing Address - Fax:856-428-5748
Practice Address - Street 1:3400 SPRUCE STREET
Practice Address - Street 2:4TH SILVERSTEIN
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-4206
Practice Address - Country:US
Practice Address - Phone:215-662-2050
Practice Address - Fax:856-428-5748
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00079700363LA2100X
PAVP005408P363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0069272Medicaid
P34534Medicare UPIN
NJ089290AFEMedicare PIN