Provider Demographics
NPI:1972564474
Name:BYNE, ROBERT S (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:BYNE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 ROUTE 6
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-4787
Mailing Address - Country:US
Mailing Address - Phone:845-628-3750
Mailing Address - Fax:845-628-5513
Practice Address - Street 1:572 ROUTE 6
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-4787
Practice Address - Country:US
Practice Address - Phone:845-628-3750
Practice Address - Fax:845-628-5513
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002932152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T48998Medicare UPIN
C31562Medicare ID - Type Unspecified