Provider Demographics
NPI:1174637854
Name:BARTOLOMEO, ROBERT S (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:S
Last Name:BARTOLOMEO
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 1:1103 STEWART AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4886
Mailing Address - Country:US
Mailing Address - Phone:516-248-3737
Mailing Address - Fax:516-248-7304
Practice Address - Street 1:1103 STEWART AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4886
Practice Address - Country:US
Practice Address - Phone:516-248-3737
Practice Address - Fax:516-248-7304
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1128621207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC07947Medicare UPIN
NY2936441Medicare PIN
NYW08521Medicare PIN