Provider Demographics
NPI:1780351684
Name:TOBAL, JUDITH E (BCHN, FNTP, IHHC)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:E
Last Name:TOBAL
Suffix:
Gender:F
Credentials:BCHN, FNTP, IHHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 AVENUE W
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-5401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:448 AVENUE W
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-5401
Practice Address - Country:US
Practice Address - Phone:347-725-1261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
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