Healthcare Provider Details

I. General information

NPI: 1356312557
Provider Name (Legal Business Name): ELIZABETH JOY ROBINSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 04/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 SOUTH ST SUITE 200
PHILADELPHIA PA
19146-1514
US

IV. Provider business mailing address

1740 SOUTH ST SUITE 200
PHILADELPHIA PA
19146-1514
US

V. Phone/Fax

Practice location:
  • Phone: 215-735-5600
  • Fax: 215-735-5680
Mailing address:
  • Phone: 215-735-5600
  • Fax: 215-735-5680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberMD057351L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: