MEDICARE: DR. LAURA E G ROBINETTE MD

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	207R00000X	Internal Medicine Physician	25MA08493300	NJ
2	208000000X	Pediatrics Physician	25MA08493300	NJ

General Provider Information

NPI Number	:	1104072693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA E G ROBINETTE MD

Provider Business Mailing Address
First Line	:	6020 RICHMOND HWY
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22303-2157
Country	:	US
Telephone Number	:	571-308-6776
Fax Number	:	877-991-8997

Provider Business Practice Location Address
First Line	:	6020 RICHMOND HWY
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22303-2157
Country	:	US
Telephone Number	:	571-308-6776
Fax Number	:	877-991-8997

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2008
Last Update Date	:	04/22/2016

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