Provider Demographics
NPI:1114162245
Name:ROBOTTI, JEANINE C (PT)
Entity Type:Individual
Prefix:MRS
First Name:JEANINE
Middle Name:C
Last Name:ROBOTTI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 REMSEN ST APT 2F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4313
Mailing Address - Country:US
Mailing Address - Phone:718-260-1000
Mailing Address - Fax:718-260-0072
Practice Address - Street 1:163 REMSEN ST APT 2F
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4313
Practice Address - Country:US
Practice Address - Phone:718-260-1000
Practice Address - Fax:718-260-0072
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008164-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400017687Medicare PIN