Provider Demographics
NPI:1306020342
Name:DR. ROBIN SEMEGRAN
Entity Type:Organization
Organization Name:DR. ROBIN SEMEGRAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMEGRAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-945-8330
Mailing Address - Street 1:71 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:PALISADES PK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-1054
Mailing Address - Country:US
Mailing Address - Phone:201-945-8330
Mailing Address - Fax:201-945-8365
Practice Address - Street 1:71 GRAND AVE
Practice Address - Street 2:
Practice Address - City:PALISADES PK
Practice Address - State:NJ
Practice Address - Zip Code:07650-1054
Practice Address - Country:US
Practice Address - Phone:201-945-8330
Practice Address - Fax:201-945-8365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4467332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0623240001Medicare NSC