1396202172 NPI number — MISS NICOLA CAMILLE ROBINSON FNP

Table of content: MISS NICOLA CAMILLE ROBINSON FNP (NPI 1396202172)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396202172 NPI number — MISS NICOLA CAMILLE ROBINSON FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBINSON
Provider First Name:
NICOLA
Provider Middle Name:
CAMILLE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396202172
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
305 E 161ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10451-3535
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-579-2500
Provider Business Mailing Address Fax Number:
718-579-2599

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
141 S CENTRAL AVE STE 205
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARTSDALE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10530-2340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-793-5588
Provider Business Practice Location Address Fax Number:
914-793-1823
Provider Enumeration Date:
02/27/2019

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: 363LF0000X , with the licence number:  342806 , 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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