Provider Demographics
NPI:1174781629
Name:HULBERT, ROBIN LYNN (PT)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:LYNN
Last Name:HULBERT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:LYNN
Other - Last Name:DAYTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:EATON CENTER 5TH FLOOR 26 CONKEY AVE, BOX 136
Mailing Address - Street 2:SECO PT/OT PLLC
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815
Mailing Address - Country:US
Mailing Address - Phone:607-334-5010
Mailing Address - Fax:607-336-7326
Practice Address - Street 1:4 CARTWRIGHT AVE
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NY
Practice Address - Zip Code:13838-1206
Practice Address - Country:US
Practice Address - Phone:607-563-2929
Practice Address - Fax:607-563-2930
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030290-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY030200000Medicaid
NY030200000Medicaid
NYRB8387Medicare PIN