MEDICARE: DR. ROBERT FIEDLER 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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	099544	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	1152045	OTHER	GHI
2	OC7088	OTHER	HEALTHNET
3	1327684640001	OTHER	CIGNA INSURANCE
4	NP618	OTHER	OXFORD
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	0120756	OTHER	AETNA INSURANCE

General Provider Information

NPI Number	:	1780788133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT FIEDLER MD

Provider Business Mailing Address
First Line	:	1175 PARK AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-1211
Country	:	US
Telephone Number	:	212-289-6500
Fax Number	:	212-996-5042

Provider Business Practice Location Address
First Line	:	1175 PARK AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-1211
Country	:	US
Telephone Number	:	212-289-6500
Fax Number	:	212-996-5042

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

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	12/17/2007

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