Provider Demographics
NPI:1720300528
Name:ROBEK, ANITA (PHARMD, MBA)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:ROBEK
Suffix:
Gender:F
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 KENMORE ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-1412
Mailing Address - Country:US
Mailing Address - Phone:718-948-8992
Mailing Address - Fax:
Practice Address - Street 1:440 9TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1620
Practice Address - Country:US
Practice Address - Phone:212-356-5264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052469-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist