Provider Demographics
NPI:1750378568
Name:CARTER-ROBIN, STEPHANIE (DPM)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:CARTER-ROBIN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8428 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7341
Mailing Address - Country:US
Mailing Address - Phone:718-424-4989
Mailing Address - Fax:718-313-0464
Practice Address - Street 1:8428 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7341
Practice Address - Country:US
Practice Address - Phone:718-424-4989
Practice Address - Fax:718-313-0464
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006168213ES0131X
GAPOD000771213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03456351Medicaid
GA000699003Medicaid
GAU61454Medicare UPIN
GA48SCCHQMedicare PIN
NYA100001794Medicare PIN