Provider Demographics
NPI:1750041471
Name:MAROSTICA, ROBIN YVONNE (PSS)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:YVONNE
Last Name:MAROSTICA
Suffix:
Gender:F
Credentials:PSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3206 ONYX AVE
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-7279
Mailing Address - Country:US
Mailing Address - Phone:541-363-1277
Mailing Address - Fax:
Practice Address - Street 1:3206 ONYX AVE
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97603-7279
Practice Address - Country:US
Practice Address - Phone:541-363-1277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-21
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORTHW000107612OtherOHA