Individual
MICHAEL ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
340 KINGSLAND ST, NUTLEY, NJ 07110-1150
(914) 380-0163
Mailing address
130 BROWN RD, SCARSDALE, NY 10583-5660
(914) 380-0163
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/10/2022
Last updated
06/29/2022
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