MEDICARE: RONALD B. ROBBINS, M.D.P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician		CT
2	207R00000X	Internal Medicine Physician		CT
3	363LF0000X	Family Nurse Practitioner	004271	CT
4	261QU0200X	Urgent Care Clinic/Center	024628	CT

General Provider Information

NPI Number	:	1013075175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD B. ROBBINS, M.D.P.C.

Provider Business Mailing Address
First Line	:	842 WASHINGTON ST
Second Line	:
City	:	MIDDLETOWN
State	:	CT
Zip	:	06457-2912
Country	:	US
Telephone Number	:	860-346-4484
Fax Number	:	860-347-1343

Provider Business Practice Location Address
First Line	:	842 WASHINGTON ST
Second Line	:
City	:	MIDDLETOWN
State	:	CT
Zip	:	06457-2912
Country	:	US
Telephone Number	:	860-346-4484
Fax Number	:	860-347-1343

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JACQUELINE NARDI
Credential	:
Telephone Number	:	860-346-4484

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	12/12/2013

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