Provider Demographics
NPI:1174504377
Name:PLUNKETT, ROBERT JAMES (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:PLUNKETT
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 STERLING DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1577
Mailing Address - Country:US
Mailing Address - Phone:716-218-1020
Mailing Address - Fax:716-677-4038
Practice Address - Street 1:200 STERLING DR
Practice Address - Street 2:SUITE 300
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1577
Practice Address - Country:US
Practice Address - Phone:716-218-1020
Practice Address - Fax:716-677-4038
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184071207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00010139603OtherUNIVERA
NY01203901Medicaid
NY0603602OtherIHA
NY000527928004OtherBC OF WNY
NY0603602OtherIHA
NYBB3269Medicare PIN