Provider Demographics
NPI:1932113149
Name:ROBINSON, WILLIAM THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:THOMAS
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 1:2200 BURDETT AVE
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180
Mailing Address - Country:US
Mailing Address - Phone:518-272-0234
Mailing Address - Fax:
Practice Address - Street 1:2200 BURDETT AVE
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-2451
Practice Address - Country:US
Practice Address - Phone:518-272-0234
Practice Address - Fax:518-272-0906
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1446771207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00952194Medicaid
NY78E75OtherEMPIRE BCBS
NYCC9024OtherRAILROAD MEDICARE
NY4342133OtherAETNA
NY10124OtherMVP
NY000401355001OtherBLUE SHIELD
NY040426006347OtherFIDELIS
NY10001728OtherCDPHP
NY104500OtherWELLCARE
NY4500OtherGHI HMO
NY50266EMedicare ID - Type Unspecified
NY00952194Medicaid