Provider Demographics
NPI:1487989794
Name:ROBEK, ADRIENNE (PHD, BCBA-D)
Entity type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:
Last Name:ROBEK
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4004 36TH AVE APT 1C
Mailing Address - Street 2:#1C
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-1543
Mailing Address - Country:US
Mailing Address - Phone:917-577-4909
Mailing Address - Fax:
Practice Address - Street 1:4004 36TH AVE APT 1C
Practice Address - Street 2:#1C
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-1543
Practice Address - Country:US
Practice Address - Phone:917-577-4909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1052417103K00000X
NY018076103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst