Provider Demographics
NPI:1245215110
Name:PRESTIANO, ROBERT ANTHONY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANTHONY
Last Name:PRESTIANO
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:CAREMOUNT MEDICAL PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-739-5172
Practice Address - Street 1:2 STOWE RD STE 5
Practice Address - Street 2:CAREMOUNT MEDICAL PC
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-2582
Practice Address - Country:US
Practice Address - Phone:914-241-1050
Practice Address - Fax:914-739-5172
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2017-01-26
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Provider Licenses
StateLicense IDTaxonomies
NY186465207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01367046Medicaid
NYA400061066Medicare PIN
NY01367046Medicaid