Provider Demographics
NPI:1740219096
Name:KAPLAN, ROBERT PHILLIP (OPHTHALMIC DISPENSER)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:PHILLIP
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:OPHTHALMIC DISPENSER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6126 220TH ST
Mailing Address - Street 2:OAKLAND GARDENS
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2245
Mailing Address - Country:US
Mailing Address - Phone:718-229-8997
Mailing Address - Fax:718-523-7466
Practice Address - Street 1:13809 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-2641
Practice Address - Country:US
Practice Address - Phone:718-739-6507
Practice Address - Fax:718-523-7466
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYC004661-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician