Provider Demographics
NPI:1386671014
Name:ISRAEL, ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:ISRAEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 WESTFALL RD
Mailing Address - Street 2:SUITE A100
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2638
Mailing Address - Country:US
Mailing Address - Phone:585-442-4141
Mailing Address - Fax:585-442-6259
Practice Address - Street 1:919 WESTFALL RD
Practice Address - Street 2:SUITE A100
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2638
Practice Address - Country:US
Practice Address - Phone:585-442-4141
Practice Address - Fax:585-442-6259
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108615207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY108615-6WOtherWORKER'S COMPENSATION
NYP01766530OtherMEDICARE RR
NY00456262Medicaid
NYCC3525- GRP:70008AMedicare PIN
NYJ400041207/GP BA0017Medicare PIN