Basic Information
| Provider Information | |||||||||
| NPI: | 1124003090 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBBINS | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | HERBERT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 32886 | ||||||||
| Address2: | BETH ISRAEL MEDICAL CENTER DEPT OF GASTROENTEROLOGY | ||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124204605 | ||||||||
| FaxNumber: | 2124204373 | ||||||||
| Practice Location | |||||||||
| Address1: | 10 UNION SQUARE E | ||||||||
| Address2: | STE 2G | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124204245 | ||||||||
| FaxNumber: | 2124204373 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2005 | ||||||||
| LastUpdateDate: | 10/29/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 220621 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 02657629 | 05 | NY | MEDICAID |