Healthcare Provider Details

I. General information

NPI: 1902104151
Provider Name (Legal Business Name): GERALD PATRICK ROBINSON MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 03/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 E TROPICANA AVE STE 201
LAS VEGAS NV
89119-6652
US

IV. Provider business mailing address

1055 E TROPICANA AVE STE 201
LAS VEGAS NV
89119-6652
US

V. Phone/Fax

Practice location:
  • Phone: 702-739-7716
  • Fax: 702-597-2242
Mailing address:
  • Phone: 702-739-7716
  • Fax: 702-597-2242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: