Healthcare Provider Details

I. General information

NPI: 1851359681
Provider Name (Legal Business Name): ROBERT MARK LINCER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 11/27/2023
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 E MAIN ST
MIDDLETOWN NY
10940-2650
US

IV. Provider business mailing address

707 E MAIN ST
MIDDLETOWN NY
10940-2650
US

V. Phone/Fax

Practice location:
  • Phone: 845-333-7575
  • Fax: 845-333-7202
Mailing address:
  • Phone: 845-333-7575
  • Fax: 845-333-7202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number030187
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number155154
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: