Provider Demographics
NPI:1992827786
Name:NATHANSON, ROBIN A (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:A
Last Name:NATHANSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E 60TH ST
Mailing Address - Street 2:SUITE 704
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1008
Mailing Address - Country:US
Mailing Address - Phone:212-242-4488
Mailing Address - Fax:212-242-3975
Practice Address - Street 1:30 E 60TH ST
Practice Address - Street 2:SUITE 704
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1008
Practice Address - Country:US
Practice Address - Phone:212-242-4488
Practice Address - Fax:212-242-3975
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0407631223G0001X, 261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental