Healthcare Provider Details

I. General information

NPI: 1487810289
Provider Name (Legal Business Name): ROBERT L PLUMMER MD FACS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 02/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 E MOSHOLU PK WY S
BRONX NY
10458-1174
US

IV. Provider business mailing address

176 E MOSHOLU PK WY S
BRONX NY
10458-1174
US

V. Phone/Fax

Practice location:
  • Phone: 718-367-6100
  • Fax: 718-733-4020
Mailing address:
  • Phone: 718-367-6100
  • Fax: 718-733-4020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT L PLUMMER
Title or Position: CEO
Credential: MD FACS PC
Phone: 718-367-6100