Provider Demographics
NPI:1124008958
Name:NOTTERMAN, ROBYN B (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBYN
Middle Name:B
Last Name:NOTTERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:601 EWING ST
Mailing Address - Street 2:SUITE C-13
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2757
Mailing Address - Country:US
Mailing Address - Phone:609-924-1033
Mailing Address - Fax:609-924-7055
Practice Address - Street 1:601 EWING ST
Practice Address - Street 2:SUITE C-13
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-2757
Practice Address - Country:US
Practice Address - Phone:609-924-1033
Practice Address - Fax:609-924-7055
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05785400207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0267484005OtherCIGNA
NJ2351569000OtherAMERIHEALTH
NJ3722194OtherAETNA
NJ2351569000OtherAMERIHEALTH
NJ087125Medicare ID - Type Unspecified