Provider Demographics
NPI:1053550194
Name:WEBSTER, TONI (DO)
Entity type:Individual
Prefix:DR
First Name:TONI
Middle Name:
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1991 MARCUS AVE
Mailing Address - Street 2:M100
Mailing Address - City:LAKE SUCCESS
Mailing Address - State:NY
Mailing Address - Zip Code:11042-2057
Mailing Address - Country:US
Mailing Address - Phone:516-472-3650
Mailing Address - Fax:516-472-3654
Practice Address - Street 1:1991 MARCUS AVE
Practice Address - Street 2:M100
Practice Address - City:LAKE SUCCESS
Practice Address - State:NY
Practice Address - Zip Code:11042-2057
Practice Address - Country:US
Practice Address - Phone:516-472-3650
Practice Address - Fax:516-472-3654
Is Sole Proprietor?:No
Enumeration Date:2009-02-12
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program