MEDICARE: DR. ROBERT WILLIAM TROBLIGER PH.D.

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	103G00000X	Clinical Neuropsychologist	68 018157	NY

General Provider Information

NPI Number	:	1548597156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT WILLIAM TROBLIGER PH.D.

Provider Business Mailing Address
First Line	:	820 2ND AVE
Second Line	:	UNIT 6C
City	:	NEW YORK
State	:	NY
Zip	:	10017-4502
Country	:	US
Telephone Number	:	212-661-7460
Fax Number	:

Provider Business Practice Location Address
First Line	:	820 2ND AVE
Second Line	:	UNIT 6C
City	:	NEW YORK
State	:	NY
Zip	:	10017-4502
Country	:	US
Telephone Number	:	212-661-7460
Fax Number	:

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

Provider Enumeration Date	:	11/03/2009
Last Update Date	:	05/27/2011

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