Provider Demographics
NPI:1427101740
Name:BLEEKER, ROBIN (PT ,MA)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:
Last Name:BLEEKER
Suffix:
Gender:F
Credentials:PT ,MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 DOWNS ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-2705
Mailing Address - Country:US
Mailing Address - Phone:201-652-4374
Mailing Address - Fax:
Practice Address - Street 1:685 RIVER AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5228
Practice Address - Country:US
Practice Address - Phone:732-364-3772
Practice Address - Fax:732-364-9064
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00288200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ40QA00288200OtherP.T. LICENSE NUMBER