Provider Demographics
NPI:1841224920
Name:ROBINSON, VIVIENNE ANGELA (PA C)
Entity Type:Individual
Prefix:MRS
First Name:VIVIENNE
Middle Name:ANGELA
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 28 161 STREET
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD GARDENS QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11434
Mailing Address - Country:US
Mailing Address - Phone:718-949-2436
Mailing Address - Fax:
Practice Address - Street 1:451 CLARKSON AVENUE
Practice Address - Street 2:KINGS COUNTY HOSPITAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:718-245-4744
Practice Address - Fax:718-245-4766
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004519207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C09147Medicare UPIN