Provider Demographics
NPI:1205801636
Name:FRISENDA, ROBERT ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANTHONY
Last Name:FRISENDA
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 1:52 HOOKER AVE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-4612
Mailing Address - Country:US
Mailing Address - Phone:845-471-5115
Mailing Address - Fax:888-519-6845
Practice Address - Street 1:52 HOOKER AVE
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-4612
Practice Address - Country:US
Practice Address - Phone:845-471-5115
Practice Address - Fax:888-519-6845
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-20
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY140446208600000X
MO2004003230208600000X
VT042-0012289208600000X
CT050199208600000X
WA60186605208600000X
NH15219208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY004334097Medicaid
NY027090OtherMVP
NY004334097Medicaid
NY027090OtherMVP