Provider Demographics
NPI:1437242112
Name:ROBINSON, HARLAND WINSLOW III (OD)
Entity Type:Individual
Prefix:DR
First Name:HARLAND
Middle Name:WINSLOW
Last Name:ROBINSON
Suffix:III
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176
Mailing Address - Country:US
Mailing Address - Phone:781-665-0897
Mailing Address - Fax:781-665-8828
Practice Address - Street 1:490 MAIN STREET
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176
Practice Address - Country:US
Practice Address - Phone:781-665-0897
Practice Address - Fax:781-665-8828
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2269152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW 15282 ROOtherBLUE CROSS BLUE SHIELD MA
MA716342OtherTUFTS
MA84357OtherUS HEALTH
MA0396575Medicaid
MA000362OtherVISION SERVICE PLAN
MA0564770001OtherDME
MA84357OtherUS HEALTH
MA0564770001OtherDME