Provider Demographics
NPI:1699814491
Name:BAKALL, S ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:S
Middle Name:ROBERT
Last Name:BAKALL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1212 E MOUNTAIN RD S
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:NY
Mailing Address - Zip Code:10516-4364
Mailing Address - Country:US
Mailing Address - Phone:845-897-4701
Mailing Address - Fax:845-831-7137
Practice Address - Street 1:121 RED SCHOOLHOUSE RD
Practice Address - Street 2:DOWNSTATE CORRECTIONAL FACILITY- FDU
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2810
Practice Address - Country:US
Practice Address - Phone:845-831-6600
Practice Address - Fax:845-831-7173
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2024-02-17
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Provider Licenses
StateLicense IDTaxonomies
NY1964952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY509828Medicare UPIN