Provider Demographics
NPI:1255024352
Name:ROBINSON, KIZZY J
Entity type:Individual
Prefix:
First Name:KIZZY
Middle Name:J
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 SICKLERVILLE RD STE 16
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-2556
Mailing Address - Country:US
Mailing Address - Phone:484-655-8064
Mailing Address - Fax:
Practice Address - Street 1:416 SICKLERVILLE RD STE 16
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-2556
Practice Address - Country:US
Practice Address - Phone:484-655-8064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0351200251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health