Provider Demographics
NPI:1316963663
Name:ARIAS, ROBIN LYNN (PA)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:LYNN
Last Name:ARIAS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:NAGY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 95000-6625
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-6625
Mailing Address - Country:US
Mailing Address - Phone:631-465-6297
Mailing Address - Fax:631-465-6524
Practice Address - Street 1:213 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:WEST SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11796-1800
Practice Address - Country:US
Practice Address - Phone:631-563-6205
Practice Address - Fax:631-563-7718
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008848363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5F4201Medicare PIN