# FURTHER NURSE PRACTITIONER IN PSYCHIATRY PRACTICE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063358711
- **Authorized official:** MICHAEL M TOBIN PMHNP-BC (OWNER/MANAGING MEMBER)
- **Authorized official phone:** (631) 318-4490

## Contact information

- **Practice address:** 609 ROUTE 109 STE 2D, WEST BABYLON, NY 11704-5000
- **Practice address phone:** (631) 318-4490
- **Practice address fax:** (631) 983-6132
- **Mailing address:** 445 BROAD HOLLOW RD, SUITE 25 \#40, MELVILLE, NY 11747
- **Mailing address phone:** (631) 318-4490
- **Mailing address fax:** (631) 983-6132

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/27/2026
- **Last updated:** 04/27/2026