Basic Information
Provider Information
NPI: 1609044890
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOLLAND
FirstName: ROBERT
MiddleName: DAVID
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: HELEN HAYES HOSPITAL
Address2: 51-55 ROUTE 9W
City: WEST HAVERSTRAW
State: NY
PostalCode: 109931195
CountryCode: US
TelephoneNumber: 8457864062
FaxNumber: 8457864526
Practice Location
Address1: HELEN HAYES HOSPITAL
Address2: 51-55 ROUTE 9W
City: WEST HAVERSTRAW
State: NY
PostalCode: 109931195
CountryCode: US
TelephoneNumber: 8457864062
FaxNumber: 8457864526
Other Information
ProviderEnumerationDate: 02/11/2008
LastUpdateDate: 04/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/07/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208100000X247528NYY Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 

No ID Information.


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