Provider Demographics
NPI:1598135048
Name:ROBINSON, JAMAL CORNELL (MS)
Entity Type:Individual
Prefix:MR
First Name:JAMAL
Middle Name:CORNELL
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2275 BRIDGE ST BLDG 5B-132
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19137-2307
Mailing Address - Country:US
Mailing Address - Phone:215-772-0101
Mailing Address - Fax:215-772-0303
Practice Address - Street 1:2275 BRIDGE ST BLDG 5B-132
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19137-2307
Practice Address - Country:US
Practice Address - Phone:215-772-0101
Practice Address - Fax:215-772-0303
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-27
Last Update Date:2015-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health