Provider Demographics
NPI:1093943961
Name:KERR, ROBERT GAWLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GAWLEY
Last Name:KERR
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 1:300 COMMUNITY DR
Mailing Address - Street 2:9TH FLOOR - NEUROSURGERY
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3816
Mailing Address - Country:US
Mailing Address - Phone:516-562-4221
Mailing Address - Fax:516-562-3631
Practice Address - Street 1:96 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2816
Practice Address - Country:US
Practice Address - Phone:631-351-4840
Practice Address - Fax:631-351-5756
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA38538207T00000X
NY272058174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
513910017Medicare PIN