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General NPI Number Information
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NPI Number | 1558690248
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Entity Type | Organization
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Legal Business Name | ROBERTS MEDICAL PC
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Dates
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Enumeration Date | 12/09/2009
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Last Update Date | 12/11/2009
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Provider Practice Location Address
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Address Line | 2417 RICHMOND RD
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2336
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Country | US
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Telephone | 732-972-5172
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Fax | 732-972-5176
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Provider Business Mailing Address
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Address Line | 30 DUNCAN DR
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1649
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Country | US
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Telephone | 732-972-5172
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Fax | 732-972-5176
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Authorized Official
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Title or Position | OFFICE MGR
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Name | MS. PATTI MORELLI
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Credential |
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Telephone | 732-972-5172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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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 | 112714-1
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License Number State | NY
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