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1912908005

NPI Code Detail

MEDICARE: ROBERT W DELORME MD

MEDICARE: ROBERT W DELORME 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	207Q00000X	Family Medicine Physician	134470	NY
2	207QG0300X	Geriatric Medicine (Family Medicine) Physician	134470	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	:	1912908005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT W DELORME MD

Provider Business Mailing Address
First Line	:	PO BOX 317
Second Line	:
City	:	HAMILTON
State	:	NY
Zip	:	13346-0317
Country	:	US
Telephone Number	:	315-824-6082
Fax Number	:	315-824-3182

Provider Business Practice Location Address
First Line	:	164 BROAD ST
Second Line	:
City	:	HAMILTON
State	:	NY
Zip	:	13346-9575
Country	:	US
Telephone Number	:	315-824-4600
Fax Number	:	315-824-8447

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	08/05/2010

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Directions to “ ROBERT W DELORME MD” Practice Location

Language	Start Address	Practice Location

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