Provider Demographics
NPI:1639677271
Name:HONOR, ROBERT VINCENT (PA)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:VINCENT
Last Name:HONOR
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:32 MONTCLAIR DR
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-1809
Mailing Address - Country:US
Mailing Address - Phone:631-626-0737
Mailing Address - Fax:
Practice Address - Street 1:181 N BELLE MEAD RD STE 6
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3495
Practice Address - Country:US
Practice Address - Phone:631-444-2599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-29
Last Update Date:2022-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021717-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant