Healthcare Provider Details

I. General information

NPI: 1013156348
Provider Name (Legal Business Name): ROBERT LUNN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2009
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 RIVERSIDE DRIVE OUR LADY OF LOURDES HOSPITAL
BINGHAMTON NY
13905
US

IV. Provider business mailing address

40 FRONT STREET, SUITE C RIVERSIDE ASSOCIATES IN ANESTHESIA, PC
BINGHAMTON NY
13905
US

V. Phone/Fax

Practice location:
  • Phone: 607-798-5111
  • Fax:
Mailing address:
  • Phone: 607-722-7264
  • Fax: 607-722-7869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number255563
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: