Individual
MR. MARK B ROBEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPNP
Contact information
Practice address
255 HEMPSTEAD ST, NEW LONDON, CT 06320-6204
(860) 443-2896
(860) 442-5909
Mailing address
255 HEMPSTEAD ST, NEW LONDON, CT 06320-6204
(860) 443-2896
(860) 442-5909
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
101.0058221
VT
363LP0200X
Pediatric Nurse Practitioner
Primary
113855
CT
363LP0200X
Pediatric Nurse Practitioner
230954
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101.0058221
ADVANCED PRACTICE RN #
VT
01
—
20051093
PNCB CERTIFICATION NUMBER
—
01
—
230954
ADVANCED PRACTICE RN NUMB
MA
Enumeration date
03/27/2007
Last updated
01/21/2015
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