Provider Demographics
NPI:1316643307
Name:TOBOIKA, ERIC (LMSW)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:TOBOIKA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 ALBANY AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-2530
Mailing Address - Country:US
Mailing Address - Phone:845-389-6166
Mailing Address - Fax:
Practice Address - Street 1:180 ALBANY AVE APT 3
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-2530
Practice Address - Country:US
Practice Address - Phone:845-389-6166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY107575104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker