Provider Demographics
NPI:1427044270
Name:WHITNEY, ROBERT B (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:WHITNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:54 OAKGROVE DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6910
Mailing Address - Country:US
Mailing Address - Phone:716-634-6158
Mailing Address - Fax:
Practice Address - Street 1:462 GRIVER SR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215
Practice Address - Country:US
Practice Address - Phone:716-898-3457
Practice Address - Fax:716-898-4424
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY122693207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01460773Medicaid
NY01460773Medicaid
NY01460773Medicaid
NY14238VMedicare ID - Type Unspecified