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General NPI Number Information
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NPI Number | 1578893210
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Entity Type | Organization
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Legal Business Name | ROBERTS MEDICAL PC
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Dates
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Enumeration Date | 12/31/2009
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Last Update Date | 12/31/2009
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Provider Practice Location Address
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Address Line | 1926 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-3518
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Country | US
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Telephone | 732-972-5172
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Fax | 732-972-5176
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Provider Business Mailing Address
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Address Line | 30 DUNCAN DR
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1649
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Country | US
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Telephone | 732-972-5172
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Fax | 732-972-5176
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Authorized Official
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Title or Position | OFFICE MGR
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Name | MRS. PATTI MORELLI
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Credential |
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Telephone | 732-972-5172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 112714
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License Number State | NY
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