Provider Demographics
NPI:1174861975
Name:MUFSON, INA ROBIN
Entity Type:Individual
Prefix:MRS
First Name:INA
Middle Name:ROBIN
Last Name:MUFSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 195
Mailing Address - Street 2:DYNAMIC CENTER
Mailing Address - City:FLORIDA
Mailing Address - State:NY
Mailing Address - Zip Code:10921
Mailing Address - Country:US
Mailing Address - Phone:845-928-9780
Mailing Address - Fax:845-928-6290
Practice Address - Street 1:2 CORPORATE DRIVE
Practice Address - Street 2:SUITE 203
Practice Address - City:CENTRAL VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10917
Practice Address - Country:US
Practice Address - Phone:845-928-9780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist