Provider Demographics
NPI:1437402484
Name:TINKLEPAUGH, ROBERT WESLEY II
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:WESLEY
Last Name:TINKLEPAUGH
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4769 LOWER RIVER RD
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:NY
Mailing Address - Zip Code:14092-1038
Mailing Address - Country:US
Mailing Address - Phone:716-609-1502
Mailing Address - Fax:866-910-3896
Practice Address - Street 1:4769 LOWER RIVER RD
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:NY
Practice Address - Zip Code:14092-1038
Practice Address - Country:US
Practice Address - Phone:716-609-1502
Practice Address - Fax:866-910-3896
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications