Provider Demographics
NPI:1154600815
Name:SEMLIATSCHENKO, ROBYN PALMERO (PA-C)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:PALMERO
Last Name:SEMLIATSCHENKO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SECOND AVENUE
Mailing Address - Street 2:MONMOUTH MEDICAL CENTER
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740
Mailing Address - Country:US
Mailing Address - Phone:732-923-7300
Mailing Address - Fax:
Practice Address - Street 1:300 2ND AVE
Practice Address - Street 2:EMERGENCY MEDICINE DEPARTMENT
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6303
Practice Address - Country:US
Practice Address - Phone:732-923-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00262700363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant