Active NPI
Phyllis Tobin, PH.D.
- Clinical Psychologist
- Hillside, NJ
National Provider Identifier
1912166356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 003612-1
- Practice address
- 61 Bauer Ter
Hillside, NJ 07205-3002 - Phone
- (908) 351-3512
- Fax
- (908) 354-7440
- NPI assigned
- Jun 2, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 003612-1 | NY | Primary |
Addresses
Primary practice location
61 Bauer Ter
Hillside, NJ 07205-3002
Mailing address
260 W 72ND St
New York, NY 10023-2817
Phone (212) 877-5353
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003612-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212364800000",
"number": "1912166356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "260 W 72ND ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100232817",
"telephone_number": "212-877-5353",
"fax_number": "908-354-7440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61 BAUER TER",
"city": "HILLSIDE",
"state": "NJ",
"postal_code": "072053002",
"telephone_number": "908-351-3512",
"fax_number": "908-354-7440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOBIN",
"first_name": "PHYLLIS",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-02",
"last_updated": "2008-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "003612-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hillside, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.