Provider Demographics
NPI:1801030473
Name:CONNORS, ROBERT D (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:CONNORS
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 1:381 PARK ST.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-4350
Mailing Address - Country:US
Mailing Address - Phone:201-546-8510
Mailing Address - Fax:201-957-7316
Practice Address - Street 1:381 PARK ST.
Practice Address - Street 2:SUITE 200
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-4350
Practice Address - Country:US
Practice Address - Phone:201-546-8510
Practice Address - Fax:201-957-7316
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2620272084N0400X
NJ25MA094193002084N0600X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0427951Medicaid