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General NPI Number Information
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NPI Number | 1316223720
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Entity Type | Individual
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Provider Name | ROBYN JEAN MIKULAS OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/30/2011
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Last Update Date | 10/30/2011
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Provider Practice Location Address
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Address Line | 100 OCEAN AVE
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City | NORTHPORT
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State | NY
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Zip | 11768-1854
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Country | US
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Telephone | 631-262-6840
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Fax |
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Provider Business Mailing Address
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Address Line | 14 HUNTINGTON RD
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City | GARDEN CITY
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State | NY
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Zip | 11530-3015
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Country | US
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Telephone | 516-248-3656
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Fax | 516-248-0995
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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