Provider Demographics
NPI:1417117730
Name:RICE, ROBERT DAVID (RN, PHD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DAVID
Last Name:RICE
Suffix:
Gender:M
Credentials:RN, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 YORK AVE
Mailing Address - Street 2:BOX 334
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6007
Mailing Address - Country:US
Mailing Address - Phone:212-639-6726
Mailing Address - Fax:212-717-3477
Practice Address - Street 1:1275 YORK AVE
Practice Address - Street 2:BOX 334
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6007
Practice Address - Country:US
Practice Address - Phone:212-639-6726
Practice Address - Fax:212-717-3477
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF30-1812363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health