Provider Demographics
NPI:1447211057
Name:HALBIG, ROBERT JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:HALBIG
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 1:112 CHARLTON RD
Mailing Address - Street 2:
Mailing Address - City:BALLSTON LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12019-2547
Mailing Address - Country:US
Mailing Address - Phone:518-399-7723
Mailing Address - Fax:518-399-6428
Practice Address - Street 1:112 CHARLTON RD
Practice Address - Street 2:
Practice Address - City:BALLSTON LAKE
Practice Address - State:NY
Practice Address - Zip Code:12019-2547
Practice Address - Country:US
Practice Address - Phone:518-399-7723
Practice Address - Fax:518-399-6428
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169011-9208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01011132Medicaid
NYD77502Medicare UPIN
NY01011132Medicaid