Basic Information
| Provider Information | |||||||||
| NPI: | 1417044504 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBOZ | ||||||||
| FirstName: | GAIL | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 575 LEXINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100226102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6469622700 | ||||||||
| FaxNumber: | 6469620115 | ||||||||
| Practice Location | |||||||||
| Address1: | 520 E 70TH ST # STARR-341 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100219800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6469622700 | ||||||||
| FaxNumber: | 6469620115 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2006 | ||||||||
| LastUpdateDate: | 09/26/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 200822 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0000X | 200822 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 207RX0202X | 200822 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | 207RH0003X | 200822 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | A400048544 | 01 | NY | MEDICARE ID | OTHER | 02-095150 | 05 | NY | MEDICAID |