Provider Demographics
NPI:1558332825
Name:DUFFY, ROBERT LLOYD (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LLOYD
Last Name:DUFFY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 WEST POST ROAD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606
Mailing Address - Country:US
Mailing Address - Phone:914-761-8525
Mailing Address - Fax:914-682-4026
Practice Address - Street 1:122 WEST POST ROAD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606
Practice Address - Country:US
Practice Address - Phone:914-761-8525
Practice Address - Fax:914-682-4026
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004076213E00000X
CT479213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01010860Medicaid
T51381Medicare UPIN
NYP4407Medicare ID - Type Unspecified