Provider Demographics
NPI:1790844686
Name:ROBBINS, LAURA (RD, CDE)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1178
Mailing Address - Street 2:
Mailing Address - City:ISLAND HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08732-1178
Mailing Address - Country:US
Mailing Address - Phone:732-506-7958
Mailing Address - Fax:732-506-6896
Practice Address - Street 1:833 ROUTE 37 W
Practice Address - Street 2:SUITE 210
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5038
Practice Address - Country:US
Practice Address - Phone:732-244-0052
Practice Address - Fax:732-506-6896
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP47494Medicare UPIN
NJ053690Medicare ID - Type Unspecified