Provider Demographics
NPI:1306974688
Name:ROBINS, SUSAN (CFNP, PNP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:ROBINS
Suffix:
Gender:F
Credentials:CFNP, PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 15TH ST APT 4L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5731
Mailing Address - Country:US
Mailing Address - Phone:718-643-9408
Mailing Address - Fax:718-643-9408
Practice Address - Street 1:PS 15, 71 SULLIVAN ST
Practice Address - Street 2:ROOM 130
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231
Practice Address - Country:US
Practice Address - Phone:718-643-9408
Practice Address - Fax:718-643-9408
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY330264-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily