MEDICARE: MR. KEITH ROBBINS MA

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1720720006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KEITH ROBBINS MA

Provider Business Mailing Address
First Line	:	300 8TH AVE APT 5O
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-6612
Country	:	US
Telephone Number	:	732-236-6018
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 8TH AVE APT 5O
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-6612
Country	:	US
Telephone Number	:	732-236-6018
Fax Number	:

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

Provider Enumeration Date	:	04/08/2022
Last Update Date	:	04/08/2022

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