Provider Demographics
NPI:1356873194
Name:ROBIN, JANE SHAJI (DO)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:SHAJI
Last Name:ROBIN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 HICKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-3415
Mailing Address - Country:US
Mailing Address - Phone:516-240-7940
Mailing Address - Fax:929-455-9802
Practice Address - Street 1:530 HICKSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-3415
Practice Address - Country:US
Practice Address - Phone:516-240-7940
Practice Address - Fax:929-455-9802
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS185912084N0400X, 2084N0400X
NY3096872084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology