Healthcare Provider Details
I. General information
NPI: 1356909618
Provider Name (Legal Business Name): ROBIN ROQUET MD, MPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/03/2019
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 LONGWOOD AVE
BOSTON MA
02115-5724
US
IV. Provider business mailing address
3401 CIVIC CENTER BOULEVARD 9NW, ROOM 55
PHILADELPHIA PA
19104
US
V. Phone/Fax
- Phone: 617-355-6000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | MT217782 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: