=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235459736
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT H STONE MS PHD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/07/2010
-----------------------------------------------------
Last Update Date | 06/07/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1858 PLEASANTVILLE RD SUITE 175
-----------------------------------------------------
City | BRIARCLIFF MANOR
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10510-1025
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-923-0068
-----------------------------------------------------
Fax | 561-374-5919
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7081 FALLS RD E
-----------------------------------------------------
City | BOYNTON BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33437-6320
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-733-3117
-----------------------------------------------------
Fax | 561-374-5919
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133N00000X
-----------------------------------------------------
Taxonomy Name | Nutritionist
-----------------------------------------------------
License Number | 004145
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 133N00000X
-----------------------------------------------------
Taxonomy Name | Nutritionist
-----------------------------------------------------
License Number | ND2904
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 133N00000X
-----------------------------------------------------
Taxonomy Name | Nutritionist
-----------------------------------------------------
License Number | LD001594
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 133N00000X
-----------------------------------------------------
Taxonomy Name | Nutritionist
-----------------------------------------------------
License Number | 450 029
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------