Provider Demographics
NPI:1770517377
Name:ROBISON, KATHRYN J (MD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:J
Last Name:ROBISON
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 1:5 PLAINSBORO ROAD, SUITE 300
Mailing Address - Street 2:PRINCETON HEALTHCARE MEDICAL ASSOCIATES
Mailing Address - City:PLAINSBOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08536
Mailing Address - Country:US
Mailing Address - Phone:609-853-7272
Mailing Address - Fax:609-853-7271
Practice Address - Street 1:5 PLAINSBORO ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536
Practice Address - Country:US
Practice Address - Phone:609-853-7272
Practice Address - Fax:609-853-7271
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05954800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ661300401Medicaid
NJ661300401Medicaid
NJ787568MW3Medicare ID - Type Unspecified