Healthcare Provider Details

I. General information

NPI: 1558409144
Provider Name (Legal Business Name): MARIE CHANTALE DEJOIE ROBINSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2007
Last Update Date: 10/27/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OAK STREET HEALTH- CAMBRIA HEIGHTS
222-19 LINDEN BLVD NY
11411
US

IV. Provider business mailing address

760 BROADWAY ROOM 2B230 DEPARTMENT OF MANAGED CARE WOODHULL MEDICAL & MENTAL HEALTH CENTER
BROOKLYN NY
11206
US

V. Phone/Fax

Practice location:
  • Phone: 718-765-6055
  • Fax:
Mailing address:
  • Phone: 718-963-8000
  • Fax: 718-630-3122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2119511
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: