Provider Demographics
NPI:1558780270
Name:AVIGDOR, ROBYN (NP)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:AVIGDOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:
Other - Last Name:APPERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:245 JUNIPER CIR E
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1930
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1346 DAVIES RD
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5107
Practice Address - Country:US
Practice Address - Phone:516-987-7464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY672612163W00000X
NYF344681363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse