Provider Demographics
NPI:1114007986
Name:BARTZ, ROBERT GREGORY (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GREGORY
Last Name:BARTZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 224
Mailing Address - Street 2:
Mailing Address - City:SHOKAN
Mailing Address - State:NY
Mailing Address - Zip Code:12481-0224
Mailing Address - Country:US
Mailing Address - Phone:845-657-5700
Mailing Address - Fax:845-657-5721
Practice Address - Street 1:3125 STATE RT. 28
Practice Address - Street 2:
Practice Address - City:SHOKAN
Practice Address - State:NY
Practice Address - Zip Code:12481
Practice Address - Country:US
Practice Address - Phone:845-657-5700
Practice Address - Fax:845-657-5721
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007985111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX1070OtherBLUE CROSS/BLUE SHIELD
NYC07985-7BOtherWORKER'S COMP
NYU59387Medicare UPIN