Provider Demographics
NPI:1285797837
Name:TOMAN, JOSEPH JOHN SR (MSW,LCSW-R)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:JOHN
Last Name:TOMAN
Suffix:SR
Gender:M
Credentials:MSW,LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 SHARON DR
Mailing Address - Street 2:
Mailing Address - City:CONKLIN
Mailing Address - State:NY
Mailing Address - Zip Code:13748-1437
Mailing Address - Country:US
Mailing Address - Phone:607-775-5695
Mailing Address - Fax:
Practice Address - Street 1:11 SHARON DR
Practice Address - Street 2:CONKLIN
Practice Address - City:CONKLIN
Practice Address - State:NY
Practice Address - Zip Code:13748-1437
Practice Address - Country:US
Practice Address - Phone:607-775-5695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0272481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical