Basic Information
| Provider Information | |||||||||
| NPI: | 1538151667 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOSEPH | ||||||||
| FirstName: | ROBYN | ||||||||
| MiddleName: | |||||||||
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| Credential: | DPM, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1165 NORTHERN BLVD | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | MANHASSET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110303048 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163654545 | ||||||||
| FaxNumber: | 5163657111 | ||||||||
| Practice Location | |||||||||
| Address1: | 1165 NORTHERN BLVD | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | MANHASSET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110303048 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163654545 | ||||||||
| FaxNumber: | 5163657111 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2005 | ||||||||
| LastUpdateDate: | 09/10/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | N004018 | NY | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No ID Information.