Provider Demographics
NPI:1053119156
Name:ROBBINS, RANDI
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:
Last Name:ROBBINS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:RANDI
Other - Middle Name:
Other - Last Name:SOLIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3 WOODED CT
Mailing Address - Street 2:
Mailing Address - City:LLOYD HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11743-9762
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 WOODED CT
Practice Address - Street 2:
Practice Address - City:LLOYD HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11743-9762
Practice Address - Country:US
Practice Address - Phone:917-748-4074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist