Healthcare Provider Details

I. General information

NPI: 1447259437
Provider Name (Legal Business Name): BETTY ROBIN FUCHS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. BETSY ROBIN SMALL

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 10/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 TROY SCHENECTADY RD SUITE 218
LATHAM NY
12110-2490
US

IV. Provider business mailing address

713 TROY SCHENECTADY RD SUITE 218
LATHAM NY
12110-2490
US

V. Phone/Fax

Practice location:
  • Phone: 518-213-0410
  • Fax: 518-640-9107
Mailing address:
  • Phone: 518-213-0410
  • Fax: 518-640-9107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number170443
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: