Healthcare Provider Details

I. General information

NPI: 1053419333
Provider Name (Legal Business Name): DANIELLE J ROBBINS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 01/09/2020
Certification Date: 01/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 N FRONTAGE RD
NEW LONDON CT
06320-2628
US

IV. Provider business mailing address

2140 MENDON RD
CUMBERLAND RI
02864-3843
US

V. Phone/Fax

Practice location:
  • Phone: 860-865-0934
  • Fax:
Mailing address:
  • Phone: 401-475-3000
  • Fax: 401-475-3204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA00416
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: