MEDICARE: JUDITH ROBB

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	022078-1	NY

General Provider Information

NPI Number	:	1124561618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH ROBB

Provider Business Mailing Address
First Line	:	10101 ROCKAWAY BLVD
Second Line	:
City	:	OZONE PARK
State	:	NY
Zip	:	11417-2228
Country	:	US
Telephone Number	:	718-322-0500
Fax Number	:

Provider Business Practice Location Address
First Line	:	10101 ROCKAWAY BLVD
Second Line	:
City	:	OZONE PARK
State	:	NY
Zip	:	11417-2228
Country	:	US
Telephone Number	:	718-322-0500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2016
Last Update Date	:	12/01/2016

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Directions to “ JUDITH ROBB ” Practice Location

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