Provider Demographics
NPI:1982859575
Name:SMITH, ROBIN B (ROBIN SMITH)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:B
Last Name:SMITH
Suffix:
Gender:F
Credentials:ROBIN SMITH
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10 OLD JACKSON AVE
Mailing Address - Street 2:#52
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-3203
Mailing Address - Country:US
Mailing Address - Phone:914-391-3354
Mailing Address - Fax:
Practice Address - Street 1:10 OLD JACKSON AVE
Practice Address - Street 2:#52
Practice Address - City:HASTINGS ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10706-3203
Practice Address - Country:US
Practice Address - Phone:914-391-3354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002054-1171W00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No171W00000XOther Service ProvidersContractor