Provider Demographics
NPI:1730551599
Name:ROBINSON, CORY
Entity type:Individual
Prefix:
First Name:CORY
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7141 ALLENTOWN RD
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-1091
Mailing Address - Country:US
Mailing Address - Phone:202-631-8343
Mailing Address - Fax:
Practice Address - Street 1:5818 ALLENTOWN WAY
Practice Address - Street 2:
Practice Address - City:CAMP SPRINGS
Practice Address - State:MD
Practice Address - Zip Code:20748-2614
Practice Address - Country:US
Practice Address - Phone:202-631-8343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD171W00000X, 174400000X, 174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No171W00000XOther Service ProvidersContractor
No174H00000XOther Service ProvidersHealth Educator