Provider Demographics
NPI:1962079103
Name:TOCCO, NINA EVELYN
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:EVELYN
Last Name:TOCCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22915 LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48082-2729
Mailing Address - Country:US
Mailing Address - Phone:586-229-4930
Mailing Address - Fax:
Practice Address - Street 1:22915 LAKE BLVD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48082-2729
Practice Address - Country:US
Practice Address - Phone:586-229-4930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist