1245683036 NPI number — MRS. TINA MARIE ROBINSON LOPEZ MASTERS DEGREE

Table of content: MRS. TINA MARIE ROBINSON LOPEZ MASTERS DEGREE (NPI 1245683036)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245683036 NPI number — MRS. TINA MARIE ROBINSON LOPEZ MASTERS DEGREE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBINSON LOPEZ
Provider First Name:
TINA MARIE
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MASTERS DEGREE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROBINSON LOPEZ
Provider Other First Name:
TINA MARIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MASTERS DEGREE
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1245683036
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/18/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
241 RICHARD CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POMONA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10970-2305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
347-683-6050
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
241 RICHARD CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POMONA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10970-2305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-683-6050
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/18/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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