MEDICARE: DR. ROBERT A NEAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	122400	NY

General Provider Information

NPI Number	:	1497921514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT A NEAL MD

Provider Business Mailing Address
First Line	:	3800 INDEPENDENCE AVE
Second Line	:	APT 3E
City	:	BRONX
State	:	NY
Zip	:	10463-1433
Country	:	US
Telephone Number	:	718-601-4013
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 INDEPENDENCE AVE
Second Line	:	APT 3E
City	:	BRONX
State	:	NY
Zip	:	10463-1433
Country	:	US
Telephone Number	:	718-601-4013
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2008
Last Update Date	:	05/08/2008

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