Provider Demographics
NPI:1073513602
Name:MOTZ, ROBIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:
Last Name:MOTZ
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 1:200 GRAND AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4371
Mailing Address - Country:US
Mailing Address - Phone:201-569-0040
Mailing Address - Fax:201-569-3244
Practice Address - Street 1:200 GRAND AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4371
Practice Address - Country:US
Practice Address - Phone:201-569-0040
Practice Address - Fax:201-569-3244
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127338207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B13251Medicare UPIN