Provider Demographics
NPI:1831108307
Name:ROBINSON, THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SPRINGSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-1837
Mailing Address - Country:US
Mailing Address - Phone:845-485-2720
Mailing Address - Fax:845-454-0405
Practice Address - Street 1:21 SPRINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-1837
Practice Address - Country:US
Practice Address - Phone:845-485-2720
Practice Address - Fax:845-454-0405
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161921207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA63282Medicare UPIN
NY56D281Medicare PIN