MEDICARE: ROBIN ALBANY APN, BC

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	363LA2200X	Adult Health Nurse Practitioner	SP009348	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SP009348	OTHER	PA	NURSE PRACTITIONER

General Provider Information

NPI Number	:	1962609792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN ALBANY APN, BC

Provider Business Mailing Address
First Line	:	838 SMITH ST
Second Line	:
City	:	TRENTON
State	:	NJ
Zip	:	08611-2712
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1025 WALNUT ST STE 607
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-5001
Country	:	US
Telephone Number	:	215-955-6317
Fax Number	:	215-923-1420

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

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	07/08/2007

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