Provider Demographics
NPI:1568833051
Name:ROBINSON, DANA (MSED)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9220 GLENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3422
Mailing Address - Country:US
Mailing Address - Phone:917-406-3524
Mailing Address - Fax:
Practice Address - Street 1:9220 GLENWOOD RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3422
Practice Address - Country:US
Practice Address - Phone:917-406-3524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-09
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY55410252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency