Provider Demographics
NPI:1194096362
Name:ROBINSON, AVRAHAM (MSW)
Entity type:Individual
Prefix:MR
First Name:AVRAHAM
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 BEACH 9TH ST
Mailing Address - Street 2:SUITE 2 C
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5636
Mailing Address - Country:US
Mailing Address - Phone:347-695-9700
Mailing Address - Fax:347-695-9701
Practice Address - Street 1:156 BEACH 9TH ST
Practice Address - Street 2:SUITE 2 C
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5636
Practice Address - Country:US
Practice Address - Phone:347-695-9700
Practice Address - Fax:347-695-9701
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY085204104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker