Basic Information
| Provider Information | |||||||||
| NPI: | 1902372782 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROBERT M. BIERNBAUM, D.O., P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 259 MONROE AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146073632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5855457200 | ||||||||
| FaxNumber: | 5852448177 | ||||||||
| Practice Location | |||||||||
| Address1: | 2225 S CLINTON AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146182664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852562210 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2018 | ||||||||
| LastUpdateDate: | 10/18/2018 | ||||||||
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| AuthorizedOfficialLastName: | BIERNBAUM | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | M. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5855457200 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | 208000000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.