Provider Demographics
NPI:1861489981
Name:PIKE, ROBERT EUGENE
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EUGENE
Last Name:PIKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-1115
Mailing Address - Country:US
Mailing Address - Phone:518-439-9207
Mailing Address - Fax:518-439-9685
Practice Address - Street 1:17 MORNINGSIDE DR
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1115
Practice Address - Country:US
Practice Address - Phone:518-439-9207
Practice Address - Fax:518-439-9685
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084983207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0849836OtherWORKERS COMP BOARD
32985CMedicare ID - Type Unspecified
NY0849836OtherWORKERS COMP BOARD