MEDICARE: DR. ROBIN HOLLANDER-BOBO MD

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	208000000X	Pediatrics Physician	196115	NY

General Provider Information

NPI Number	:	1265429450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBIN HOLLANDER-BOBO MD

Provider Business Mailing Address
First Line	:	2416 OCEAN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3509
Country	:	US
Telephone Number	:	718-332-0011
Fax Number	:	718-332-1855

Provider Business Practice Location Address
First Line	:	2416 OCEAN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3509
Country	:	US
Telephone Number	:	718-332-0011
Fax Number	:	718-332-1855

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

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	07/08/2007

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