Provider Demographics
NPI:1649389339
Name:BROMBERG, ROBIN RHONDA (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:RHONDA
Last Name:BROMBERG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 MOREWOOD OAKS STE 100
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1624
Mailing Address - Country:US
Mailing Address - Phone:516-767-7220
Mailing Address - Fax:516-944-9427
Practice Address - Street 1:58 MOREWOOD OAKS
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-1624
Practice Address - Country:US
Practice Address - Phone:516-767-7220
Practice Address - Fax:516-944-9427
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3461111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1001495OtherAMERICAN SPECIALTIES HEAL
NY1C8145OtherHEALTHNET
NY2218184OtherAETNA US HEALTHCARE
NY373795OtherUNITED HEALTHCARE
NYX5L472OtherEMPIRE BLUE CROSS BLUE SH
NY938353OtherLANDMARK
NY802180OtherMPN
NY931383OtherACN
NY3461-3OtherWORKERS COMP
NYP801227OtherOXFORD
NYU67486Medicare UPIN
NYX94721Medicare ID - Type Unspecified