Provider Demographics
NPI:1306141585
Name:MOORE, ROBIN CYLINTHIA (DO)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:CYLINTHIA
Last Name:MOORE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:CYLINTHIA
Other - Last Name:MCKINNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:18 BLOOMER DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-3689
Mailing Address - Country:US
Mailing Address - Phone:917-580-0726
Mailing Address - Fax:
Practice Address - Street 1:222 W 116TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026
Practice Address - Country:US
Practice Address - Phone:212-454-0400
Practice Address - Fax:212-545-0401
Is Sole Proprietor?:No
Enumeration Date:2011-01-19
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY268901207Q00000X
NJ25MB09084900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine