Provider Demographics
NPI:1609268572
Name:BISHTON, ROBERT RAY III (BC-HIS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:RAY
Last Name:BISHTON
Suffix:III
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NY
Mailing Address - Zip Code:13346-0034
Mailing Address - Country:US
Mailing Address - Phone:315-750-9693
Mailing Address - Fax:
Practice Address - Street 1:4 EATON ST STE M-1A
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NY
Practice Address - Zip Code:13346-1102
Practice Address - Country:US
Practice Address - Phone:315-750-2064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-02
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000001738237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist