Provider Demographics
NPI:1700183555
Name:ROBINSON, SOPHIA
Entity Type:Individual
Prefix:MISS
First Name:SOPHIA
Middle Name:
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 1:4 LIS CT
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-2228
Mailing Address - Country:US
Mailing Address - Phone:973-342-2832
Mailing Address - Fax:
Practice Address - Street 1:4 LIS CT
Practice Address - Street 2:
Practice Address - City:SAYREVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08872-2228
Practice Address - Country:US
Practice Address - Phone:973-342-2832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY276781164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse