Provider Demographics
NPI:1366528812
Name:ROBINSON, SANDRA A (MD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:A
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 02 LINDEN BLVD.
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11411-1206
Mailing Address - Country:US
Mailing Address - Phone:718-527-2850
Mailing Address - Fax:718-977-1089
Practice Address - Street 1:21902 LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:CAMBRIA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11411-1619
Practice Address - Country:US
Practice Address - Phone:718-527-2850
Practice Address - Fax:718-977-1089
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210441207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01863583Medicaid
NY01863583Medicaid
NYG74143Medicare UPIN