=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487770277
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CAROL ROBIN D.C., C.C.N.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2007
-----------------------------------------------------
Last Update Date | 02/13/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 275 FAIR ST SUITE 23
-----------------------------------------------------
City | KINGSTON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12401-3800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-657-7545
-----------------------------------------------------
Fax | 845-853-1609
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 269 JOHN JOY RD
-----------------------------------------------------
City | WOODSTOCK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12498-2220
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-657-7545
-----------------------------------------------------
Fax | 845-853-1609
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | X2813
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------