Provider Demographics
NPI:1225571383
Name:GARA, ROBIN (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:GARA
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1954 1ST AVE
Mailing Address - Street 2:APT 6V
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6415
Mailing Address - Country:US
Mailing Address - Phone:315-436-8826
Mailing Address - Fax:
Practice Address - Street 1:3009 BROADWAY
Practice Address - Street 2:LOWER LEVEL BROOKS HALL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-6909
Practice Address - Country:US
Practice Address - Phone:212-854-2091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY669313163W00000X, 163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY669313OtherNURSING LICENSE