Toly Tin

Primary specialty

PharmacistTaxonomy code 183500000X

License

124962 Issued in MN

Practice address

1960 Twin Lakes Pkwy
Roseville, MN 55113-1324

Phone

(612) 788-1478

NPI assigned

Oct 11, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602374400000",
    "number": "1972101152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5619 84 1/2 AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554432171",
            "telephone_number": "763-607-9461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 TWIN LAKES PKWY",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131324",
            "telephone_number": "612-788-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIN",
        "first_name": "TOLY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-11",
        "last_updated": "2020-10-11",
        "certification_date": "2020-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "124962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BOARD OF PHARMACY LICENSE",
            "identifier": "124962",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Connexus",
            "affiliation": "N",
            "address_1": "1960 Twin Lakes Pkwy",
            "city": "Roseville",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551131324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Three Rivers Pathology PA
• Krista Thuening, PHARMD
• Jessica A Thurber, R.N.
• Deann K Thurner, R.N.
• Kavyamol Thyagarajan, DO
• Sharon Toetschinger III
• Taylor A Tolbert, BS, LADC
• Lisa Tollefson, PHARM.D.
• Cole Tomkins, MSC, BCBA, LBA
• Kara Lynn Tomlinson, MD

• Pharmacist in Roseville, MN
• Providers in Roseville, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.