Provider Demographics
NPI:1508098351
Name:GOMOLIN, ROBIN ESTHER (PSYAD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:ESTHER
Last Name:GOMOLIN
Suffix:
Gender:F
Credentials:PSYAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 WALLIS RD
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3113
Mailing Address - Country:US
Mailing Address - Phone:617-325-5713
Mailing Address - Fax:
Practice Address - Street 1:154 WALLIS RD
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-3113
Practice Address - Country:US
Practice Address - Phone:617-325-5713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000703-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst