Provider Demographics
NPI:1689748204
Name:ROBERT E TODD MD PC
Entity Type:Organization
Organization Name:ROBERT E TODD MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-426-0200
Mailing Address - Street 1:8100 OSWEGO RD
Mailing Address - Street 2:STE 210
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-1662
Mailing Address - Country:US
Mailing Address - Phone:315-426-0200
Mailing Address - Fax:315-426-0283
Practice Address - Street 1:8100 OSWEGO RD
Practice Address - Street 2:STE 210
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13090-1662
Practice Address - Country:US
Practice Address - Phone:315-426-0200
Practice Address - Fax:315-426-0283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty