Healthcare Provider Details

I. General information

NPI: 1013041342
Provider Name (Legal Business Name): JOANNA ANNETTE ROBIN PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 10/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 BROADWAY SUITE 601
NEW YORK NY
10019-1903
US

IV. Provider business mailing address

3515 HENRY HUDSON PKWY 8D
BRONX NY
10463-1326
US

V. Phone/Fax

Practice location:
  • Phone: 212-246-5747
  • Fax:
Mailing address:
  • Phone: 917-608-5741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number68 017832
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: