Provider Demographics
NPI:1578715579
Name:CORPOLONGO, ROBIN (MS, PT)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:
Last Name:CORPOLONGO
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SUMMIT WAY
Mailing Address - Street 2:
Mailing Address - City:PURDYS
Mailing Address - State:NY
Mailing Address - Zip Code:10578-1414
Mailing Address - Country:US
Mailing Address - Phone:914-276-2814
Mailing Address - Fax:914-276-2814
Practice Address - Street 1:7 SUMMIT WAY
Practice Address - Street 2:
Practice Address - City:PURDYS
Practice Address - State:NY
Practice Address - Zip Code:10578-1414
Practice Address - Country:US
Practice Address - Phone:914-276-2814
Practice Address - Fax:914-276-2814
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012850-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics