Healthcare Provider Details

I. General information

NPI: 1568419802
Provider Name (Legal Business Name): TINA M ROBAKIEWICZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 01/24/2020
Certification Date: 01/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 PROSPECT ST MILFORD REGIONAL MEDICAL CENTER
MILFORD MA
01757-3003
US

IV. Provider business mailing address

9 INDUSTRIAL RD SUITE 5
MILFORD MA
01757-3588
US

V. Phone/Fax

Practice location:
  • Phone: 508-473-1190
  • Fax:
Mailing address:
  • Phone: 508-473-1480
  • Fax: 508-473-1210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number78503
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number78503
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: