Provider Demographics
NPI:1467767368
Name:BLACKBURN SIGLEY, ROBIN (OTR)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:BLACKBURN SIGLEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-6566
Mailing Address - Country:US
Mailing Address - Phone:908-591-5410
Mailing Address - Fax:
Practice Address - Street 1:895 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-6566
Practice Address - Country:US
Practice Address - Phone:908-591-5410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00386500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist