Healthcare Provider Details

I. General information

NPI: 1669472031
Provider Name (Legal Business Name): ROBIN WEEMS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431C SAVANNAH RD
LEWES DE
19958-1460
US

IV. Provider business mailing address

20 GRAND ST FL 3
WARWICK NY
10990-1035
US

V. Phone/Fax

Practice location:
  • Phone: 26-444-2823
  • Fax:
Mailing address:
  • Phone: 845-368-5000
  • Fax: 845-987-5979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number005073
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: