Provider Demographics
NPI:1083627483
Name:COLE, ROBERT ESMONDE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ESMONDE
Last Name:COLE
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 1:722 W WATER ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14905-2435
Mailing Address - Country:US
Mailing Address - Phone:607-271-2050
Mailing Address - Fax:
Practice Address - Street 1:7575 STATE ROUTE 54
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:NY
Practice Address - Zip Code:14810-7930
Practice Address - Country:US
Practice Address - Phone:607-776-7357
Practice Address - Fax:607-776-7129
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116699208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00394963Medicaid
NY020053677OtherRAILROAD MEDICARE #
NY00394963Medicaid
NYJ400067067Medicare PIN