Provider Demographics
NPI:1902867989
Name:KOTZ, ROBERT ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALAN
Last Name:KOTZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:800 IRVING AVE
Mailing Address - Street 2:PSYCHIATRY SERVICE 116A, VAMC
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2716
Mailing Address - Country:US
Mailing Address - Phone:315-425-4400
Mailing Address - Fax:315-425-3447
Practice Address - Street 1:800 IRVING AVE
Practice Address - Street 2:PSYCHIATRY SERVICE 116A, VAMC
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2716
Practice Address - Country:US
Practice Address - Phone:315-425-4400
Practice Address - Fax:315-425-3447
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2007-07-08
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1616172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry