Provider Demographics
NPI:1215033246
Name:FOX, ROBERT S (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:FOX
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 TROY-SCHENECTADY RD.
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110
Mailing Address - Country:US
Mailing Address - Phone:518-374-8001
Mailing Address - Fax:518-374-5923
Practice Address - Street 1:1202 TROY-SCHENECTADY RD.
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110
Practice Address - Country:US
Practice Address - Phone:518-374-8001
Practice Address - Fax:518-374-5923
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV4535152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist