Provider Demographics
NPI:1659646271
Name:ROBINSON, MOYA SUZANNE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MOYA
Middle Name:SUZANNE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 CROMPOND RD
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-3922
Mailing Address - Country:US
Mailing Address - Phone:914-382-1239
Mailing Address - Fax:
Practice Address - Street 1:1601 CROMPOND RD
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-3922
Practice Address - Country:US
Practice Address - Phone:914-382-1239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282793-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse