Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD019295E | PA |
N | 2080A0000X | Adolescent Medicine | MD019295E | PA |
NPI | 1043374432 |
---|---|
Provider Name | Dr. Clarice Anita Robinson |
First Address | Philadelphia, PA 19120-2421 |
Second Address | Philadelphia, PA 19141-3018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 27/01/2009 |