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General NPI Number Information
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NPI Number | 1992027643
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Entity Type | Individual
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Provider Name | ROBIN FAULK NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 02/23/2010
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Last Update Date | 02/19/2016
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Provider Practice Location Address
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Address Line | 2576 BROADWAY #510
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City | NEW YORK
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State | NY
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Zip | 10025-5654
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Country | US
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Telephone | 646-827-9568
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5756
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City | ALBANY
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State | NY
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Zip | 12205-0756
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Country | US
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Telephone | 646-827-9568
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 338301
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00491000
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License Number State | NJ
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