Provider Demographics
NPI:1568400844
Name:ROBINSON, JOSEPH JACOB (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JACOB
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 GRANT AVENUE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-2542
Mailing Address - Country:US
Mailing Address - Phone:215-464-6600
Mailing Address - Fax:215-464-2379
Practice Address - Street 1:3110 GRANT AVENUE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-2542
Practice Address - Country:US
Practice Address - Phone:215-464-6600
Practice Address - Fax:215-464-2379
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002437L111N00000X
PAAK000464L171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA427183LAXMedicare PIN
PAT30368Medicare UPIN