Healthcare Provider Details

I. General information

NPI: 1396889820
Provider Name (Legal Business Name): ROBIN ELLEN IONIN-KAUFMAN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 MADISON AVE
WEST HEMPSTEAD NY
11552-2354
US

IV. Provider business mailing address

34 OAK DR
PLAINVIEW NY
11803-2726
US

V. Phone/Fax

Practice location:
  • Phone: 516-564-9216
  • Fax:
Mailing address:
  • Phone: 516-935-8390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number2181941-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: