Provider Demographics
NPI:1881857159
Name:ROBINSON, JAMES NATHAN (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:NATHAN
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 1:148 39TH ST FL 7
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-2550
Mailing Address - Country:US
Mailing Address - Phone:646-422-5929
Mailing Address - Fax:646-422-5930
Practice Address - Street 1:148 39TH ST FL 7
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-2550
Practice Address - Country:US
Practice Address - Phone:646-422-5929
Practice Address - Fax:646-422-5930
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN54467207QS0010X
MS22313207QS0010X
NY302216207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL140883Medicaid
MS02979213Medicaid
AR27385001Medicaid
TNQ024097Medicaid
MS02979213Medicaid
AL140883Medicaid