Provider Demographics
NPI:1316775554
Name:ROBBYS BUNDLE OF JOY
Entity type:Organization
Organization Name:ROBBYS BUNDLE OF JOY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EMPLOYEE
Authorized Official - Prefix:MS
Authorized Official - First Name:SHATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:315-240-7072
Mailing Address - Street 1:1218 HART ST # 1
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-4551
Mailing Address - Country:US
Mailing Address - Phone:315-240-7072
Mailing Address - Fax:
Practice Address - Street 1:1218 HART ST # 1
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-4551
Practice Address - Country:US
Practice Address - Phone:315-240-7072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty