Provider Demographics
NPI:1063434280
Name:ROBINS, JEFFREY G (OD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:G
Last Name:ROBINS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1268 SUMNER AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01118
Mailing Address - Country:US
Mailing Address - Phone:413-782-5339
Mailing Address - Fax:413-783-6290
Practice Address - Street 1:1268 SUMNER AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01118
Practice Address - Country:US
Practice Address - Phone:413-782-5339
Practice Address - Fax:413-783-6290
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5175152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232799OtherBC/BS
IL5282810001OtherDMER
ILU51006Medicare UPIN
IL02232799OtherBC/BS