Provider Demographics
NPI:1306814975
Name:STRUHL, ROBERT EVAN (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:EVAN
Last Name:STRUHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:410 LAKEVILLE RD STE 209
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1122
Mailing Address - Country:US
Mailing Address - Phone:516-488-5050
Mailing Address - Fax:516-326-6252
Practice Address - Street 1:833 NORTHERN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5308
Practice Address - Country:US
Practice Address - Phone:516-488-5050
Practice Address - Fax:516-487-0147
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2022-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY140179207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01838724Medicaid
NY30F901Medicare ID - Type Unspecified
NYE87260Medicare UPIN