Healthcare Provider Details

I. General information

NPI: 1215209192
Provider Name (Legal Business Name): EMILY ROBINSON HALEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2012
Last Update Date: 10/14/2021
Certification Date: 10/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 EASTERN AVE JHBMC EMERGENCY DEPARTMENT
BALTIMORE MD
21224
US

IV. Provider business mailing address

4940 EASTERN AVE JHBMC EMERGENCY DEPARTMENT
BALTIMORE MD
21224
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-0350
  • Fax:
Mailing address:
  • Phone: 410-550-0350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: