Provider Demographics
NPI:1639231137
Name:ROY, ROBERT D (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:ROY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 LARCHMONT AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-2869
Mailing Address - Country:US
Mailing Address - Phone:914-834-1418
Mailing Address - Fax:914-834-3437
Practice Address - Street 1:132 LARCHMONT AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-2869
Practice Address - Country:US
Practice Address - Phone:914-834-1418
Practice Address - Fax:914-834-3437
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1779342084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY90F412Medicare PIN
NY90F411Medicare PIN