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NPI Code Detail

MEDICARE: MICHAEL ROBILOTTI PA-C

MEDICARE:   MICHAEL  ROBILOTTI  PA-C
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
1363A00000XPhysician Assistant014134NY

General Provider Information

NPI Number : 1285949859
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ROBILOTTI PA-C
Provider Business Mailing Address
First Line : 4143 HYLAN BLVD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10308-3308
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4143 HYLAN BLVD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10308-3308
Country : US
Telephone Number : 718-233-1300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2010
Last Update Date : 03/15/2013

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Directions to “ MICHAEL ROBILOTTI PA-C” Practice Location

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