Provider Demographics
NPI:1669554713
Name:AGRI, ROBYN (MD)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:AGRI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2381 LAWRENCEVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648
Mailing Address - Country:US
Mailing Address - Phone:609-896-8152
Mailing Address - Fax:609-896-4107
Practice Address - Street 1:2381 LAWRENCEVILLE ROAD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648
Practice Address - Country:US
Practice Address - Phone:609-896-8152
Practice Address - Fax:609-896-4107
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037091E208100000X
NJ25MA05347500208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AG572897Medicare ID - Type Unspecified
C32688Medicare UPIN