Provider Demographics
NPI:1598859548
Name:ROBIN, MARC (MD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:ROBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:32 STRAWBERRY HILL CT
Mailing Address - Street 2:FLOOR 4, SUITE 6
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2594
Mailing Address - Country:US
Mailing Address - Phone:203-977-2566
Mailing Address - Fax:203-977-2568
Practice Address - Street 1:32 STRAWBERRY HILL CT
Practice Address - Street 2:SUITE 41096
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2594
Practice Address - Country:US
Practice Address - Phone:203-977-2566
Practice Address - Fax:203-977-2568
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT038064207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001380641Medicaid
CTH07151Medicare UPIN
CT001380641Medicaid