Provider Demographics
NPI:1033103312
Name:ROBBINS, WILLIAM JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JAMES
Last Name:ROBBINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-2810
Mailing Address - Country:US
Mailing Address - Phone:631-741-4323
Mailing Address - Fax:631-751-6488
Practice Address - Street 1:4 MEADOW DR
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-2810
Practice Address - Country:US
Practice Address - Phone:631-741-4323
Practice Address - Fax:631-751-6488
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162576207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5489C1OtherEMPIRE BC/BS
NY01548250Medicaid
NY48D331Medicare ID - Type Unspecified
NY5489C1OtherEMPIRE BC/BS