MEDICARE: AILEEN 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	163W00000X	Registered Nurse	336034-1	NY

General Provider Information

NPI Number	:	1740572890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AILEEN ROBB

Provider Business Mailing Address
First Line	:	1025 E 241ST ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-1019
Country	:	US
Telephone Number	:	917-375-7918
Fax Number	:

Provider Business Practice Location Address
First Line	:	1025 E 241ST ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-1019
Country	:	US
Telephone Number	:	917-375-7918
Fax Number	:

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

Provider Enumeration Date	:	05/09/2011
Last Update Date	:	05/09/2011

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