Provider Demographics
NPI:1588973382
Name:ROBBINS, SHERI L (COTA)
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:L
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 SHERYL CRES
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-1321
Mailing Address - Country:US
Mailing Address - Phone:631-724-1006
Mailing Address - Fax:
Practice Address - Street 1:63 SHERYL CRES
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-1321
Practice Address - Country:US
Practice Address - Phone:631-724-1005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005563-1171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor