Provider Demographics
NPI:1124011234
Name:JELLINGER, ROBERT MARTIN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARTIN
Last Name:JELLINGER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:NEW YORK HARBOR VA HEALTHCARE CENTER, BROOKLYN CAMPUS
Mailing Address - Street 2:800 POLY PLACE
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209
Mailing Address - Country:US
Mailing Address - Phone:718-836-6600
Mailing Address - Fax:718-630-3761
Practice Address - Street 1:NEW YORK HARBOR VA HEALTHCARE CENTER, BROOKLYN CAMPUS
Practice Address - Street 2:800 POLY PLACE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209
Practice Address - Country:US
Practice Address - Phone:718-836-6600
Practice Address - Fax:718-630-3761
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2019-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY233777207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02590201Medicaid
NY02590201Medicaid
NYE59280Medicare UPIN