Provider Demographics
NPI:1982910659
Name:ROBIN H. FUGAZZI, INC.
Entity Type:Organization
Organization Name:ROBIN H. FUGAZZI, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:HOLMES
Authorized Official - Last Name:FUGAZZI
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:207-794-3253
Mailing Address - Street 1:78 HOOVER LANE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:ME
Mailing Address - Zip Code:04457-4647
Mailing Address - Country:US
Mailing Address - Phone:207-794-3253
Mailing Address - Fax:
Practice Address - Street 1:23 ELLA P. BURR ROAD
Practice Address - Street 2:ELLA P. BURR ELEMENTARY SCHOOL
Practice Address - City:LINCOLN
Practice Address - State:ME
Practice Address - Zip Code:04457-4647
Practice Address - Country:US
Practice Address - Phone:207-794-3253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT331225X00000X
MA169225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty