Individual
MRS. KSENIYA ROBENOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP, RN
Contact information
Practice address
147-56 COOLIDGE AVE, BRIARWOOD, NY 11435
(347) 730-1198
Mailing address
147-56 COOLIDGE AVE, BRIARWOOD, NY 11435
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
646394
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
308122
NY
Other
Enumeration date
09/07/2012
Last updated
02/28/2017
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