Provider Demographics
NPI:1063588390
Name:TOJINO, CONRADO A SR (MD)
Entity type:Individual
Prefix:DR
First Name:CONRADO
Middle Name:A
Last Name:TOJINO
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 STONY BROOK CT
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-6524
Mailing Address - Country:US
Mailing Address - Phone:845-561-1538
Mailing Address - Fax:
Practice Address - Street 1:600 STONY BROOK CT
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-6524
Practice Address - Country:US
Practice Address - Phone:845-561-1538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108443174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB19563Medicare UPIN