Provider Demographics
NPI:1194445866
Name:ROBBINS, MACKENZIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8294 E FLOYD RD
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-0646
Mailing Address - Country:US
Mailing Address - Phone:315-225-6134
Mailing Address - Fax:
Practice Address - Street 1:44 DWIGHT AVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NY
Practice Address - Zip Code:13323-1600
Practice Address - Country:US
Practice Address - Phone:315-723-2886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049231-01208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics