Provider Demographics
NPI:1356312557
Name:ROBINSON, ELIZABETH JOY (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JOY
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 SOUTH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1514
Mailing Address - Country:US
Mailing Address - Phone:215-735-5600
Mailing Address - Fax:215-735-5680
Practice Address - Street 1:1740 SOUTH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1514
Practice Address - Country:US
Practice Address - Phone:215-735-5600
Practice Address - Fax:215-735-5680
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD057351L2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF70140Medicare UPIN
080592Medicare ID - Type Unspecified