Provider Demographics
NPI:1043519127
Name:ROBINSON, NICHOLAS
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
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 1:1020 15TH ST
Mailing Address - Street 2:28H
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-2300
Mailing Address - Country:US
Mailing Address - Phone:207-570-9913
Mailing Address - Fax:
Practice Address - Street 1:5460 S BOSTON ST
Practice Address - Street 2:HERITAGE CLUB GREENWOOD VILLAGE
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111
Practice Address - Country:US
Practice Address - Phone:888-888-4489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-15
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1200133225100000X
COPTL.0012015225100000X
MEPT3712225100000X
FLPT27321225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist