MEDICARE: MR. ANTHONY E ROBERETS NP

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	163W00000X	Registered Nurse	6048801	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	408548	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	:	1790927515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANTHONY E ROBERETS NP

Provider Business Mailing Address
First Line	:	16215 HIGHLAND AVE APT 7G
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11432-3461
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16215 HIGHLAND AVE APT 7G
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11432-3461
Country	:	US
Telephone Number	:	917-673-1710
Fax Number	:

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

Provider Enumeration Date	:	03/25/2009
Last Update Date	:	06/03/2026

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