Healthcare Provider Details

I. General information

NPI: 1447244165
Provider Name (Legal Business Name): ROBIN EASTMAN-ABAYA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 07/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 RIVERSIDE DR
BINGHAMTON NY
13905-4246
US

IV. Provider business mailing address

5 W STATE ST
BINGHAMTON NY
13901-2322
US

V. Phone/Fax

Practice location:
  • Phone: 607-798-5219
  • Fax: 607-798-6707
Mailing address:
  • Phone: 607-772-9462
  • Fax: 607-772-1223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number169639
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: