Provider Demographics
NPI:1366461170
Name:ROBBINS, MICHAEL JONATHAN (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JONATHAN
Last Name:ROBBINS
Suffix:
Gender:M
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:ONE GUSTAV L. LEVY PLACE-BOX 1030
Mailing Address - Street 2:THE MOUNT SINAI HOSPITAL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:718-760-0011
Mailing Address - Fax:718-760-0685
Practice Address - Street 1:9436 58TH AVE
Practice Address - Street 2:SUITE G4
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5149
Practice Address - Country:US
Practice Address - Phone:718-760-0011
Practice Address - Fax:718-760-0685
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150797207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1366461170Medicaid
NYG400027022Medicare UPIN
NY49024Medicare PIN