Provider Demographics
NPI:1306695242
Name:TOBOROWSKY, MICHELLE (RN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:TOBOROWSKY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 STOWEBURY RD
Mailing Address - Street 2:
Mailing Address - City:WATERBURY CENTER
Mailing Address - State:VT
Mailing Address - Zip Code:05677-7170
Mailing Address - Country:US
Mailing Address - Phone:732-908-9636
Mailing Address - Fax:
Practice Address - Street 1:213 HIERING AVE APT 1
Practice Address - Street 2:
Practice Address - City:SEASIDE HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08751-1755
Practice Address - Country:US
Practice Address - Phone:723-908-9636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR3680100251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care