MEDICARE: DR. ROBERT F COYNE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0001X	Clinical Cardiac Electrophysiology Physician	MA67409	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093746646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT F COYNE MD

Provider Business Mailing Address
First Line	:	PO BOX 416457
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02241-6457
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 MADISON AVE
Second Line	:	BOX 5, ELECTROPHYSIOLOGY DEPT
City	:	MORRISTOWN
State	:	NJ
Zip	:	07962-1956
Country	:	US
Telephone Number	:	973-971-4261
Fax Number	:	973-290-7253

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	09/29/2016

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