Healthcare Provider Details
I. General information
NPI: 1992110209
Provider Name (Legal Business Name): CHELSEA ROBBINS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/25/2014
Last Update Date: 05/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6 FOREST AVE STE 205
PARAMUS NJ
07652-5241
US
IV. Provider business mailing address
11 WELLESLEY ST
MAPLEWOOD NJ
07040-3227
US
V. Phone/Fax
- Phone: 201-596-4524
- Fax:
- Phone: 201-596-4524
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 26NJ00632900 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | F401525-1 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 630223-1 |
| License Number State | NY |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 26NR18516400 |
| License Number State | NJ |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 03886275 |
| Identifier Type | MEDICAID |
| Identifier State | NY |
| Identifier Issuer | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: