Provider Demographics
NPI:1801324579
Name:VANBUSKIRK, ROBIN
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:VANBUSKIRK
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 1:110 HAVERHILL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-2119
Mailing Address - Country:US
Mailing Address - Phone:978-378-3358
Mailing Address - Fax:
Practice Address - Street 1:587 N DEER ISLE RD
Practice Address - Street 2:
Practice Address - City:DEER ISLE
Practice Address - State:ME
Practice Address - Zip Code:04627-3438
Practice Address - Country:US
Practice Address - Phone:207-348-2351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2017-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOA3204224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant