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General NPI Number Information
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NPI Number | 1376135335
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Entity Type | Individual
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Provider Name | JASON ULYSSES ROBINSON FNP
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Gender | Male
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Dates
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Enumeration Date | 02/10/2021
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Last Update Date | 02/10/2021
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Provider Practice Location Address
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Address Line | 518 JAMES ST STE B60
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City | SYRACUSE
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State | NY
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Zip | 13203-4213
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Country | US
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Telephone | 315-423-5039
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Fax |
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Provider Business Mailing Address
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Address Line | 464 WELLINGTON AVE
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City | ROCHESTER
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State | NY
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Zip | 14619-1848
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Country | US
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Telephone | 585-752-3858
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F346659
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License Number State | NY
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