Provider Demographics
NPI:1720245764
Name:ROBINSON, ALBERT M (LMSW)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:M
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178-00 LINDEN BLVD
Mailing Address - Street 2:E WING ROOM 231
Mailing Address - City:ST. ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11425
Mailing Address - Country:US
Mailing Address - Phone:718-526-1000
Mailing Address - Fax:718-298-8529
Practice Address - Street 1:17800 LINDEN BLVD
Practice Address - Street 2:E WING 2ND FLOOR ROOM 231
Practice Address - City:ST. ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11425-0000
Practice Address - Country:US
Practice Address - Phone:718-526-1000
Practice Address - Fax:718-298-8529
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094217-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00244019Medicaid