Provider Demographics
NPI:1790093888
Name:LUGO, ROBYN (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:
Last Name:LUGO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:ROBYN
Other - Middle Name:
Other - Last Name:DOBBINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:117 CHARLOTTE TER
Mailing Address - Street 2:
Mailing Address - City:ROSELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07204-2406
Mailing Address - Country:US
Mailing Address - Phone:908-377-5464
Mailing Address - Fax:
Practice Address - Street 1:475 SEAVIEW AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3436
Practice Address - Country:US
Practice Address - Phone:718-226-9000
Practice Address - Fax:718-226-9955
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028664225100000X
NJ40QA01245500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist