Healthcare Provider Details

I. General information

NPI: 1295652717
Provider Name (Legal Business Name): KELLIE ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9181 SOMERSET DR
BARKER NY
14012-9654
US

IV. Provider business mailing address

9181 SOMERSET DR
BARKER NY
14012-9654
US

V. Phone/Fax

Practice location:
  • Phone: 716-969-1648
  • Fax:
Mailing address:
  • Phone: 716-969-1648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: