Provider Demographics
NPI:1013075175
Name:RONALD B. ROBBINS, M.D.P.C.
Entity Type:Organization
Organization Name:RONALD B. ROBBINS, M.D.P.C.
Other - Org Name:PREFERRED CARE WALK-IN MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NARDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-346-4484
Mailing Address - Street 1:842 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-2912
Mailing Address - Country:US
Mailing Address - Phone:860-346-4484
Mailing Address - Fax:860-347-1343
Practice Address - Street 1:842 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-2912
Practice Address - Country:US
Practice Address - Phone:860-346-4484
Practice Address - Fax:860-347-1343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT207Q00000X, 207R00000X
CT024628261QU0200X
CT004271363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB84122Medicare UPIN
CTC00548Medicare PIN
CTA97133Medicare UPIN
CTD02459Medicare UPIN