MEDICARE: ROBIN R WATSON MSN APRN

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	207RH0003X	Hematology & Oncology Physician	002940	CT
2	363L00000X	Nurse Practitioner	002940	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	004396174	OTHER	CT	CHNCT

General Provider Information

NPI Number	:	1235114273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN R WATSON MSN APRN

Provider Business Mailing Address
First Line	:	12 CASE ST
Second Line	:	STE 212
City	:	NORWICH
State	:	CT
Zip	:	06360-2222
Country	:	US
Telephone Number	:	860-859-9123
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 WASHINGTON ST
Second Line	:	EASTERN CT HEMATOLOGY & ONCOLOGY SUITE 220
City	:	NORWICH
State	:	CT
Zip	:	06360-2700
Country	:	US
Telephone Number	:	860-886-8362
Fax Number	:	860-886-9262

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

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	04/07/2022

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