Provider Demographics
NPI:1205508090
Name:ROBBINS, DEBORAH ANN (RN BSN MPA)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:RN BSN MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 FAIRMOUNT AVENUE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:14750
Mailing Address - Country:US
Mailing Address - Phone:716-483-5999
Mailing Address - Fax:
Practice Address - Street 1:110 WINCHESTER RD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NY
Practice Address - Zip Code:14750-1739
Practice Address - Country:US
Practice Address - Phone:716-474-1303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY278273-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse