=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801129713
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MERLE S ROBINSON M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2009
-----------------------------------------------------
Last Update Date | 09/09/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 210 E 15TH ST 11E
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10003-3922
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-614-3288
-----------------------------------------------------
Fax | 212-614-3288
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 210 E 15TH ST 11E
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10003-3922
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-614-3288
-----------------------------------------------------
Fax | 212-614-3288
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084F0202X
-----------------------------------------------------
Taxonomy Name | Forensic Psychiatry Physician
-----------------------------------------------------
License Number | 158682
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------