Provider Demographics
NPI:1245213339
Name:ROBINSON, SUZZETTE N (MA)
Entity Type:Individual
Prefix:MS
First Name:SUZZETTE
Middle Name:N
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660130
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-0130
Mailing Address - Country:US
Mailing Address - Phone:718-454-0806
Mailing Address - Fax:718-454-0916
Practice Address - Street 1:6118 190TH ST
Practice Address - Street 2:SUITE 234
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-2723
Practice Address - Country:US
Practice Address - Phone:718-454-0806
Practice Address - Fax:718-454-0916
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY197255207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG00374Medicare UPIN