Provider Demographics
NPI:1538151667
Name:JOSEPH, ROBYN (DPM, PC)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:DPM, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1165 NORTHERN BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3048
Mailing Address - Country:US
Mailing Address - Phone:516-365-4545
Mailing Address - Fax:516-365-7111
Practice Address - Street 1:1165 NORTHERN BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3048
Practice Address - Country:US
Practice Address - Phone:516-365-4545
Practice Address - Fax:516-365-7111
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004018213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT51472Medicare UPIN
NYP45941Medicare ID - Type UnspecifiedMEDICARE NUMBER