Provider Demographics
NPI:1740222850
Name:ROBINSON, PETER S (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:S
Last Name:ROBINSON
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 1:31 SHERMAN ST
Mailing Address - Street 2:SUITE 2400
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-7079
Mailing Address - Country:US
Mailing Address - Phone:716-483-5306
Mailing Address - Fax:716-483-5307
Practice Address - Street 1:31 SHERMAN ST
Practice Address - Street 2:SUITE 2400
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-7079
Practice Address - Country:US
Practice Address - Phone:716-483-5306
Practice Address - Fax:716-483-5307
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYB81414207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY593779Medicaid
NY593779Medicaid
NYB81414Medicare UPIN