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General NPI Number Information
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NPI Number | 1073162343
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Entity Type | Organization
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Legal Business Name | KOFI ROBERTSON MD PLLC
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 09/09/2019
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Provider Practice Location Address
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Address Line | 28-10 JACKSON AVENUE
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101
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Country | US
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Telephone | 908-917-6532
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Fax |
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Provider Business Mailing Address
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Address Line | 28-10 JACKSON AVENUE
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101
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Country | US
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Telephone | 908-917-6532
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Fax |
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Authorized Official
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Title or Position | ANESTHESIOLOGIST
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Name | NII AMON ROBERTSON
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Credential | MD
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Telephone | 908-917-6532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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