Provider Demographics
NPI:1699444679
Name:ANTHONY ROBINSON XXI LLC
Entity type:Organization
Organization Name:ANTHONY ROBINSON XXI LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-918-3601
Mailing Address - Street 1:20 JONES AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02124-4116
Mailing Address - Country:US
Mailing Address - Phone:617-918-3601
Mailing Address - Fax:
Practice Address - Street 1:545 WASHINGTON ST
Practice Address - Street 2:3
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-0212
Practice Address - Country:US
Practice Address - Phone:617-918-3601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279P4000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPatient TransportGroup - Multi-Specialty
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA23222OtherPRIVATE
MAA2025024Medicaid