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NPI Code Detail

MEDICARE: DEAN DEROBERTS MD

MEDICARE:   DEAN  DEROBERTS  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
1208200000XPlastic Surgery PhysicianME95604FL
2208200000XPlastic Surgery Physician256232NY

General Provider Information

NPI Number : 1396771424
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEAN DEROBERTS MD
Provider Business Mailing Address
First Line : 3107 E GENESEE ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13224-1646
Country : US
Telephone Number : 315-299-5313
Fax Number : 315-299-5616
Provider Business Practice Location Address
First Line : 3107 E GENESEE ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13224-1646
Country : US
Telephone Number : 315-299-5313
Fax Number : 315-299-5661
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 08/15/2024

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Directions to “ DEAN DEROBERTS MD” Practice Location

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