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General NPI Number Information
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NPI Number | 1972691632
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Entity Type | Organization
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Legal Business Name | ROBERT K. HEINEMAN JR., MD PC
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | 23 LA GRANGE RD
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City | DELMAR
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State | NY
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Zip | 12054-3712
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Country | US
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Telephone | 518-439-8444
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Fax |
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Provider Business Mailing Address
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Address Line | 23 LA GRANGE RD
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City | DELMAR
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State | NY
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Zip | 12054-3712
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Country | US
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Telephone | 518-439-8444
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT K. HEINEMAN JR.
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Credential | MD
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Telephone | 518-439-8444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 087518-1
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License Number State | NY
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