1649389339 NPI number — DR. ROBIN RHONDA BROMBERG D.C.

Table of content: ADELAIDA STAMENOVA FNP-BC (NPI 1477262491)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649389339 NPI number — DR. ROBIN RHONDA BROMBERG D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROMBERG
Provider First Name:
ROBIN
Provider Middle Name:
RHONDA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
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:
1649389339
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/13/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
58 MOREWOOD OAKS STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORT WASHINGTON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11050-1624
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-767-7220
Provider Business Mailing Address Fax Number:
516-944-9427

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
58 MOREWOOD OAKS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORT WASHINGTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11050-1624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-767-7220
Provider Business Practice Location Address Fax Number:
516-944-9427
Provider Enumeration Date:
08/29/2006

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: 111N00000X , with the licence number:  3461 , 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)

  • Identifier: 1001495 . This is a "AMERICAN SPECIALTIES HEAL" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1C8145 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2218184 . This is a "AETNA US HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 373795 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: X5L472 . This is a "EMPIRE BLUE CROSS BLUE SH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 938353 . This is a "LANDMARK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 802180 . This is a "MPN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 931383 . This is a "ACN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3461-3 . This is a "WORKERS COMP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P801227 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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