Healthcare Provider Details

I. General information

NPI: 1073187233
Provider Name (Legal Business Name): ROBYN NOELLE D'AGOSTINO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 STONE HILL RD APT E04
SPRINGFIELD NJ
07081-2122
US

IV. Provider business mailing address

100 STONE HILL RD APT E04
SPRINGFIELD NJ
07081-2122
US

V. Phone/Fax

Practice location:
  • Phone: 908-420-0137
  • Fax:
Mailing address:
  • Phone: 908-420-0137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA12630000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: