Provider Demographics
NPI:1982022257
Name:MAYO-ROBINSON, WANDA (FNP, RN-BC)
Entity Type:Individual
Prefix:MS
First Name:WANDA
Middle Name:
Last Name:MAYO-ROBINSON
Suffix:
Gender:F
Credentials:FNP, RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 AVON CIRCLE
Mailing Address - Street 2:UNIT C
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-2027
Mailing Address - Country:US
Mailing Address - Phone:845-553-2449
Mailing Address - Fax:
Practice Address - Street 1:510 COURTLANDT AVE FL 6
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5032
Practice Address - Country:US
Practice Address - Phone:347-577-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY351604363LF0000X
NY22 624787163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)