Healthcare Provider Details

I. General information

NPI: 1275804189
Provider Name (Legal Business Name): ROBINSON PA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2012
Last Update Date: 05/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 BARNES RD STE 201
WALLINGFORD CT
06492-1832
US

IV. Provider business mailing address

85 BARNES RD STE 201
WALLINGFORD CT
06492-1832
US

V. Phone/Fax

Practice location:
  • Phone: 800-909-9220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: BEN ROBINSON
Title or Position: OWNER
Credential:
Phone: 800-909-5866