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General NPI Number Information
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NPI Number | 1497283907
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Entity Type | Individual
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Provider Name | SEDHENE ROBINSON DPA, PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/28/2017
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 51 N ELM ST
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City | WATERBURY
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State | CT
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Zip | 06702-1545
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Country | US
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Telephone | 845-445-5169
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Fax |
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Provider Business Mailing Address
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Address Line | 1065 SOUTHERN BLVD
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City | BRONX
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State | NY
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Zip | 10459-2417
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 54428
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 022392
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4724
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License Number State | CT
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