Provider Demographics
NPI:1467725515
Name:BIONDO, ROBIN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:
Last Name:BIONDO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 TRAP FALLS RD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-4616
Mailing Address - Country:US
Mailing Address - Phone:203-734-7900
Mailing Address - Fax:
Practice Address - Street 1:2 TRAP FALLS RD
Practice Address - Street 2:SUITE 404
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4616
Practice Address - Country:US
Practice Address - Phone:203-734-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000051225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant