| Dr Robin Layne Kornegay-rougeau, MD | |
| 1 Park Way, Haverhill, MA 01830-6278 | |
| (978) 521-3230 | |
| (978) 521-3256 | 
| Full Name | Dr Robin Layne Kornegay-rougeau | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics | 
| Location | 1 Park Way, Haverhill, Massachusetts | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1760465397 | NPI | - | NPPES | 
| 110091496A | Medicaid | MA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | 249640 (Massachusetts) | Primary | 
| Entity Name | Mass General Brigham Community Physicians Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1891112637 PECOS PAC ID: 1759273436 Enrollment ID: O20150723007726 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Robin Layne Kornegay-rougeau, MD 1 Park Way, Haverhill, MA 01830-6278 Ph: (978) 521-3230 | Dr Robin Layne Kornegay-rougeau, MD 1 Park Way, Haverhill, MA 01830-6278 Ph: (978) 521-3230 | 
| Steven P. Bloom, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1 Parkway, Haverhill, MA 01830 Phone: 978-521-3230 Fax: 978-521-3256 | |
| Carl F. Rosenbloom, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1 Parkway, Haverhill, MA 01830 Phone: 978-521-3230 Fax: 978-521-3256 | |
| Dr. Christine Daragjati Riccardi, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2 Water St, Haverhill, MA 01830 Phone: 978-373-6557 Fax: 978-374-5096 | |
| Paula Boulanger, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Parkway, Haverhill, MA 01830 Phone: 978-521-3230 Fax: 978-521-3256 | |
| Sherwood B Lee, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1 Parkway, Haverhill, MA 01830 Phone: 978-521-3230 Fax: 978-521-3256 | |
| Terence Edward Moran, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 288 Groveland St, Unit C-3, Haverhill, MA 01830 Phone: 978-521-8108 Fax: 978-521-8372 | |
| Mrs. Lisa M Fitzgibbons, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Parkway, Haverhill, MA 01830 Phone: 978-521-3230 Fax: 978-521-3256 |