Provider Demographics
NPI:1811210610
Name:HUTCHINSON, ROBERT EARL (LPN)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:EARL
Last Name:HUTCHINSON
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170-29 118TH AVE
Mailing Address - Street 2:
Mailing Address - City:QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11434-2215
Mailing Address - Country:US
Mailing Address - Phone:347-753-7582
Mailing Address - Fax:
Practice Address - Street 1:17029 118TH AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-2215
Practice Address - Country:US
Practice Address - Phone:347-753-7582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299714-1164W00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No251E00000XAgenciesHome Health