Provider Demographics
NPI:1316962780
Name:RUSS-MEEK, ROBYN L (DO)
Entity type:Individual
Prefix:DR
First Name:ROBYN
Middle Name:L
Last Name:RUSS-MEEK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 RTE 46
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2695
Mailing Address - Country:US
Mailing Address - Phone:908-813-9788
Mailing Address - Fax:908-813-9782
Practice Address - Street 1:57 RTE 46
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2695
Practice Address - Country:US
Practice Address - Phone:908-813-9788
Practice Address - Fax:908-813-9782
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB06297800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8016208Medicaid
NJ8016208Medicaid
NJ029612Medicare ID - Type Unspecified