Provider Demographics
NPI:1104264944
Name:WEISSMAN, ROBIN V (RD, MSW)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:V
Last Name:WEISSMAN
Suffix:
Gender:F
Credentials:RD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:476 HUNGRY HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-3647
Mailing Address - Country:US
Mailing Address - Phone:917-991-1093
Mailing Address - Fax:
Practice Address - Street 1:476 HUNGRY HARBOR RD
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-3647
Practice Address - Country:US
Practice Address - Phone:917-991-1093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001659-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered