Provider Demographics
NPI:1972588986
Name:BRIGHT-POOLE, ROBBIE ANN (MS CCCA)
Entity Type:Individual
Prefix:MRS
First Name:ROBBIE
Middle Name:ANN
Last Name:BRIGHT-POOLE
Suffix:
Gender:F
Credentials:MS CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 BRICK BLVD
Mailing Address - Street 2:BUILDING 4 SUITE 114
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7984
Mailing Address - Country:US
Mailing Address - Phone:732-920-7171
Mailing Address - Fax:732-920-7722
Practice Address - Street 1:74 BRICK BLVD
Practice Address - Street 2:BUILDING 4 SUITE 114
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7984
Practice Address - Country:US
Practice Address - Phone:732-920-7171
Practice Address - Fax:732-920-7722
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00024900237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
S03078Medicare UPIN
212878P5AMedicare ID - Type Unspecified