Provider Demographics
NPI:1134202682
Name:ROBINSON, DAVID E (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56850 ROUTE 25
Mailing Address - Street 2:
Mailing Address - City:SOUTHOLD
Mailing Address - State:NY
Mailing Address - Zip Code:11971-4725
Mailing Address - Country:US
Mailing Address - Phone:631-765-1191
Mailing Address - Fax:
Practice Address - Street 1:56850 ROUTE 25
Practice Address - Street 2:
Practice Address - City:SOUTHOLD
Practice Address - State:NY
Practice Address - Zip Code:11971-4725
Practice Address - Country:US
Practice Address - Phone:631-765-1191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006237111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX49581Medicare ID - Type Unspecified
NYU02670Medicare UPIN