Provider Demographics
NPI:1245683036
Name:ROBINSON LOPEZ, TINA MARIE (MASTERS DEGREE)
Entity type:Individual
Prefix:MRS
First Name:TINA MARIE
Middle Name:
Last Name:ROBINSON LOPEZ
Suffix:
Gender:F
Credentials:MASTERS DEGREE
Other - Prefix:MRS
Other - First Name:TINA MARIE
Other - Middle Name:
Other - Last Name:ROBINSON LOPEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MASTERS DEGREE
Mailing Address - Street 1:241 RICHARD CT
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-2305
Mailing Address - Country:US
Mailing Address - Phone:347-683-6050
Mailing Address - Fax:
Practice Address - Street 1:241 RICHARD CT
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-2305
Practice Address - Country:US
Practice Address - Phone:347-683-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist