Provider Demographics
NPI:1841439585
Name:THOMPSON-LABISSIERE, ROBIN DENESE (DPT)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:DENESE
Last Name:THOMPSON-LABISSIERE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:DENESE
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:24605 136TH RD
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-1654
Mailing Address - Country:US
Mailing Address - Phone:718-675-9912
Mailing Address - Fax:
Practice Address - Street 1:24605 136TH RD
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-1654
Practice Address - Country:US
Practice Address - Phone:718-675-9912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028132-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist