Provider Demographics
NPI:1003216094
Name:VOLTAIRE, ROBBLIE DIANA (LPN)
Entity Type:Individual
Prefix:
First Name:ROBBLIE
Middle Name:DIANA
Last Name:VOLTAIRE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 E 53RD ST APT C3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2554
Mailing Address - Country:US
Mailing Address - Phone:347-703-0630
Mailing Address - Fax:
Practice Address - Street 1:50 CLINTON ST STE 601
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-4282
Practice Address - Country:US
Practice Address - Phone:347-703-0630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY318995-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse