Individual
EILEEN A TOBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
435 LEWIS AVE, MERIDEN, CT 06451
(203) 694-8200
Mailing address
435 LEWIS AVE, MIDSTATE MEDICAL CENTER, MERIDEN, CT 06451
(203) 694-8200
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
00707
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000707
CONNECTICARE
CT
05
—
00422971300
—
CT
Enumeration date
11/20/2006
Last updated
10/26/2012
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