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Organization

FURTHER NURSE PRACTITIONER IN PSYCHIATRY PRACTICE PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL M TOBIN PMHNP-BC (OWNER/MANAGING MEMBER)
(631) 318-4490
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
04/27/2026
Last updated
04/27/2026
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