Provider Demographics
NPI:1558471334
Name:THOMPSON, ROBIN E (MD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:E
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WEST CARVER ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743
Mailing Address - Country:US
Mailing Address - Phone:631-421-0020
Mailing Address - Fax:631-421-4738
Practice Address - Street 1:200 WEST CARVER ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743
Practice Address - Country:US
Practice Address - Phone:631-421-0020
Practice Address - Fax:631-421-4738
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184010-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CIMOtherWCB RATING CODE
1336805OtherUNITED
16978OtherVYTRA
TR4010OtherATLANTIS
110052712OtherRRMC
112234962OtherCIGNA
184010OtherMEDICAL LICENSE NUMBER
4231328OtherAETNA
080OtherNEW YORK MEDICAID SPECIAL
OC8781OtherHEALTHNET
NY01305499Medicaid
0C8781OtherCARECORE
1840107OtherWC/NF
CP677OtherOXFORD
184010OtherHIP
RT004G9910OtherBLUE CROSS AND BLUE SHIEL
RT004G9910OtherMEDICARE ID
RT004G9910OtherMEDICARE ID
0C8781OtherCARECORE
NY04G991Medicare ID - Type Unspecified