Provider Demographics
NPI:1013720606
Name:TOGBA, ERIC TOE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:TOE
Last Name:TOGBA
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 SUMMIT DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02324-2177
Mailing Address - Country:US
Mailing Address - Phone:617-901-9233
Mailing Address - Fax:
Practice Address - Street 1:600 SOUTH ST W STE 4F
Practice Address - Street 2:
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767-5171
Practice Address - Country:US
Practice Address - Phone:617-901-9233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-29
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2310366363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty