Healthcare Provider Details

I. General information

NPI: 1376450429
Provider Name (Legal Business Name): ROBINSON JAVANTI MOORE RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 CENTRE AVE
NEW ROCHELLE NY
10801-7212
US

IV. Provider business mailing address

757 E 169TH ST
BRONX NY
10456-2664
US

V. Phone/Fax

Practice location:
  • Phone: 917-944-7991
  • Fax:
Mailing address:
  • Phone: 917-944-7991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2834576
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: