Healthcare Provider Details

I. General information

NPI: 1306025358
Provider Name (Legal Business Name): ROBYN A. COTLER MS RD CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2007
Last Update Date: 06/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 OLD COUNTRY ROAD
PLAINVIEW NY
11803
US

IV. Provider business mailing address

5 HICKMAN ST
SYOSSET NY
11791
US

V. Phone/Fax

Practice location:
  • Phone: 516-433-9496
  • Fax: 516-931-1273
Mailing address:
  • Phone: 516-433-9496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number004597
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: