Provider Demographics
NPI:1962950709
Name:VASQUEZ BARROS, ROBINSON F
Entity type:Individual
Prefix:
First Name:ROBINSON
Middle Name:F
Last Name:VASQUEZ BARROS
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 1:15 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-4003
Mailing Address - Country:US
Mailing Address - Phone:914-434-8356
Mailing Address - Fax:
Practice Address - Street 1:15 CHARLES ST
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-4003
Practice Address - Country:US
Practice Address - Phone:914-434-8356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-21
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY318214164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse