Healthcare Provider Details

I. General information

NPI: 1689511735
Provider Name (Legal Business Name): MABEL ROBINSON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3916 VINEYARD DR
DUNKIRK NY
14048-3522
US

IV. Provider business mailing address

12612 TREVETT RD
SPRINGVILLE NY
14141-9202
US

V. Phone/Fax

Practice location:
  • Phone: 716-413-0038
  • Fax:
Mailing address:
  • Phone: 716-431-2661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number035557
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: