Provider Demographics
NPI:1164950614
Name:NEMEROFF, ROBIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:
Last Name:NEMEROFF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 CHESTNUT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10977-6330
Mailing Address - Country:US
Mailing Address - Phone:917-514-0887
Mailing Address - Fax:
Practice Address - Street 1:811 CHESTNUT RIDGE RD
Practice Address - Street 2:
Practice Address - City:CHESTNUT RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10977-6330
Practice Address - Country:US
Practice Address - Phone:917-514-0887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-29
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014643-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical