Provider Demographics
NPI:1689754582
Name:ROBINSON, TIMOTHY THOMAS (DO)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:THOMAS
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32-45 BELL BLVD
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361
Mailing Address - Country:US
Mailing Address - Phone:718-631-0072
Mailing Address - Fax:718-428-7126
Practice Address - Street 1:32-45 BELL BLVD
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361
Practice Address - Country:US
Practice Address - Phone:718-631-0072
Practice Address - Fax:718-428-7126
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS-6720207Q00000X
NY1666921207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY13F651Medicare PIN
NY89203Medicare PIN
E39109Medicare UPIN