Provider Demographics
NPI:1578529939
Name:ROBBINS, RUSSELL D (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:D
Last Name:ROBBINS
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Gender:M
Credentials:MD, MBA
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Mailing Address - Street 1:22 SEIR HILL RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-4203
Mailing Address - Country:US
Mailing Address - Phone:203-945-9405
Mailing Address - Fax:917-210-3336
Practice Address - Street 1:530 5TH AVE
Practice Address - Street 2:18TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-5101
Practice Address - Country:US
Practice Address - Phone:646-457-4798
Practice Address - Fax:917-210-3336
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2016-04-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT039114208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G02428Medicare UPIN