Provider Demographics
NPI:1942328125
Name:ROBINE, KATIE (MSPT)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:ROBINE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:CAPUTI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSPT
Mailing Address - Street 1:429 WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:ATCO
Mailing Address - State:NJ
Mailing Address - Zip Code:08004-2227
Mailing Address - Country:US
Mailing Address - Phone:856-753-1111
Mailing Address - Fax:
Practice Address - Street 1:111 VINE ST
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1447
Practice Address - Country:US
Practice Address - Phone:609-704-7007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01113700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ089306T2UMedicare ID - Type Unspecified