Provider Demographics
NPI:1073507521
Name:NEWBORN, ROBERT J (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:NEWBORN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-302-8610
Practice Address - Street 1:360 N BEDFORD RD
Practice Address - Street 2:MOUNT KISCO MEDICAL GROUP, PC
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-1143
Practice Address - Country:US
Practice Address - Phone:914-241-1050
Practice Address - Fax:914-302-8610
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY171643207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2041761Medicaid
NYA400136940Medicare PIN
E44820Medicare UPIN
P2540362OtherOXFORD HEALTH PLAN
3C5202OtherHEALTHNET GROUP PIN
7958203OtherAETNA-PPO
0000000819741OtherGHI-HMO
10037869OtherCDPHP
E44820Medicare UPIN
2504625OtherAETNA - HMO
50105000056OtherFIDELIS CARE OF NY
NYTAX IDOtherCHN SOLUTIONS PROVIDER ID
NY43F08EU121Medicare PIN