Provider Demographics
NPI:1366685802
Name:ROBESON-GEWUERZ, KIMBERLY RACHEL (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:RACHEL
Last Name:ROBESON-GEWUERZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 NEW SCOTLAND AVE # MC-70
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3412
Mailing Address - Country:US
Mailing Address - Phone:518-262-5226
Mailing Address - Fax:
Practice Address - Street 1:43 NEW SCOTLAND AVE # MC-70
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-262-5226
Practice Address - Fax:518-262-6261
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC396932084N0008X
CT0519322084N0008X, 2084N0400X
NY308796-012084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine