Provider Demographics
NPI:1912313057
Name:NEUKAM, ROBIN LYNN (PTA)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:LYNN
Last Name:NEUKAM
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 ELKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21409-5477
Mailing Address - Country:US
Mailing Address - Phone:443-224-7948
Mailing Address - Fax:
Practice Address - Street 1:35 MILKSHAKE LN
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21403-1507
Practice Address - Country:US
Practice Address - Phone:410-269-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA4112225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant