Provider Demographics
NPI:1477507341
Name:PAUL, HENRY ROBERT (MD)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:ROBERT
Last Name:PAUL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3839 FLATLANDS AVENUE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3533
Mailing Address - Country:US
Mailing Address - Phone:347-907-2992
Mailing Address - Fax:718-338-3176
Practice Address - Street 1:3839 FLATLANDS AVENUE
Practice Address - Street 2:SUITE 102
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3533
Practice Address - Country:US
Practice Address - Phone:347-907-2992
Practice Address - Fax:718-338-3176
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2019-09-19
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Provider Licenses
StateLicense IDTaxonomies
NY179494207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2257990011OtherCIGNA
NY11879OtherELDERPLAN
NY2593288OtherGHI
NYP00097219OtherRR MEDICARE
NY0569153OtherAETNA US HEALTHCARE
NY01749531Medicaid
NY179494-A18OtherHIP
NYP2522623OtherOXFORD
NY038AO2OtherBLUE CROSS
NYBK00143OtherAMERICHOICE
NY2593288OtherGHI
NY179494-A18OtherHIP