Provider Demographics
NPI:1699076067
Name:ROBIN APPLE, LLC
Entity type:Organization
Organization Name:ROBIN APPLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:APPLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:301-645-3867
Mailing Address - Street 1:10206 ROCKVIEW TER
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20623-1237
Mailing Address - Country:US
Mailing Address - Phone:301-782-7553
Mailing Address - Fax:
Practice Address - Street 1:11170 MALL CIR
Practice Address - Street 2:C/O SEARS OPTICAL
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4866
Practice Address - Country:US
Practice Address - Phone:301-645-3867
Practice Address - Fax:301-932-7656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1516152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD139445Medicaid