Provider Demographics
NPI:1346210028
Name:GILFERT, ROBERT LEE (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEE
Last Name:GILFERT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4305 FASSETT LN
Mailing Address - Street 2:
Mailing Address - City:WELLSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14895-9327
Mailing Address - Country:US
Mailing Address - Phone:585-593-3900
Mailing Address - Fax:585-593-3901
Practice Address - Street 1:4305 FASSETT LN
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14895-9327
Practice Address - Country:US
Practice Address - Phone:585-593-3900
Practice Address - Fax:585-593-3901
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4553213ES0131X
NYN004553-1213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01159604Medicaid
NY000510739001OtherBLUE CROSS BLUE SHIELD
NY0316540001OtherDMERC PTAN
NY000510739001OtherBLUE CROSS BLUE SHIELD
NYU02392Medicare UPIN