Provider Demographics
NPI:1477534352
Name:HAIM, ROBERT VICTOR (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:VICTOR
Last Name:HAIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:908 NIAGARA FALLS BLVD
Mailing Address - Street 2:STE 208
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120
Mailing Address - Country:US
Mailing Address - Phone:716-692-3302
Mailing Address - Fax:716-362-9518
Practice Address - Street 1:621 10TH ST
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14302
Practice Address - Country:US
Practice Address - Phone:716-278-4337
Practice Address - Fax:716-362-9518
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY136176246Q00000X
NY1361762207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Q00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Pathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA4102Medicare PIN
NYF93152Medicare UPIN