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General NPI Number Information
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NPI Number | 1225108798
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Entity Type | Individual
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Provider Name | ROBERT R PURVIN D.O.
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Gender | Male
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 10/27/2009
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Provider Practice Location Address
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Address Line | 1757 FRONT ST
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City | EAST MEADOW
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State | NY
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Zip | 11554-2432
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Country | US
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Telephone | 516-967-2829
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Fax | 516-489-6861
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Provider Business Mailing Address
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Address Line | 1757 FRONT ST
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City | EAST MEADOW
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State | NY
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Zip | 11554-2432
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Country | US
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Telephone | 516-967-2829
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Fax | 516-489-6861
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 190960-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 190960-1
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License Number State | NY
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