Basic Information
| Provider Information | |||||||||
| NPI: | 1609856996 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOLNAY | ||||||||
| FirstName: | GABOR | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 779 | ||||||||
| Address2: | |||||||||
| City: | CONNERSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 473310779 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7658251903 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1941 VIRGINIA AVE | ||||||||
| Address2: | |||||||||
| City: | CONNERSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 473312833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7658255131 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/20/2006 | ||||||||
| LastUpdateDate: | 09/01/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0105X | 01027181 | IN | N | Allopathic & Osteopathic Physicians | Pathology | Clinical Pathology/Laboratory Medicine | 207ZP0102X | 01027181 | IN | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | 000000031256 | 01 | IN | BLUE SHIELD-REID HOSP | OTHER | 100368300 | 05 | IN | MEDICAID | 2048064 | 05 | OH | MEDICAID |