Provider Demographics
NPI:1265579858
Name:ROBERTSON-PARRIS, CELINA M (ANP)
Entity type:Individual
Prefix:MRS
First Name:CELINA
Middle Name:M
Last Name:ROBERTSON-PARRIS
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 MARTENSE AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2504
Mailing Address - Country:US
Mailing Address - Phone:212-844-8026
Mailing Address - Fax:212-844-8037
Practice Address - Street 1:10 UNION SQUARE EAST
Practice Address - Street 2:BETH ISRAEL MEDICAL CENTER PACC LL61
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-844-8026
Practice Address - Fax:212-844-8037
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302038163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02968216Medicaid
NY02968216Medicaid