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General NPI Number Information
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NPI Number | 1316208002
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Entity Type | Individual
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Provider Name | ROBERT FIRTH PICKELS JR. MD
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Gender | Male
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 03/04/2014
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Provider Practice Location Address
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Address Line | 267 HILL ROAD
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City | ROME
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State | NY
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Zip | 13441
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Country | US
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Telephone | 315-338-7540
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Fax | 315-338-7538
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Provider Business Mailing Address
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Address Line | 4621 E SENECA ST
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City | SHERRILL
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State | NY
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Zip | 13461-1025
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Country | US
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Telephone | 315-363-2046
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 106450-1
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License Number State | NY
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