Provider Demographics
NPI:1477084705
Name:ROBINSON, SHONDA (DPT)
Entity Type:Individual
Prefix:DR
First Name:SHONDA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 AMBOY AVENUE, EDISON, NJ, USA
Mailing Address - Street 2:SUITE 002
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3579
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:629 AMBOY AVENUE, EDISON, NJ, USA
Practice Address - Street 2:SUITE 002
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3579
Practice Address - Country:US
Practice Address - Phone:732-661-1500
Practice Address - Fax:732-661-1505
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01475400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist