MEDICARE: DR. ROBERT EYCKMANS

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	1223G0001X	General Practice Dentistry	036248	NY

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	:	1447261128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT EYCKMANS

Provider Business Mailing Address
First Line	:	1931 3RD AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-4004
Country	:	US
Telephone Number	:	212-348-8824
Fax Number	:

Provider Business Practice Location Address
First Line	:	1931 3RD AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-4004
Country	:	US
Telephone Number	:	212-348-8824
Fax Number	:

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

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	05/04/2012

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