Healthcare Provider Details

I. General information

NPI: 1821237249
Provider Name (Legal Business Name): ROBERT L. WHITE NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2009
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 PROSPECT AVE
PLATTSBURGH NY
12901-1302
US

IV. Provider business mailing address

PO BOX 22239
NEW YORK NY
10087-0001
US

V. Phone/Fax

Practice location:
  • Phone: 201-654-6397
  • Fax: 201-608-9241
Mailing address:
  • Phone: 201-654-6397
  • Fax: 201-608-9241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11006565
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF307948
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: