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General NPI Number Information
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NPI Number | 1639408305
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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 | 12/09/2009
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Last Update Date | 12/09/2009
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Provider Practice Location Address
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Address Line | 2035 RALPH AVE
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City | BROOKLYN
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State | NY
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Zip | 11234-5300
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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 | BILLING DEPT
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Name | MS. TINA SHALLONIS
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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 | 112714-1
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License Number State | NY
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