Provider Demographics
NPI:1245269661
Name:ROBB, STEPHEN SARGENT (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:SARGENT
Last Name:ROBB
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 1:630 BAY RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-1241
Mailing Address - Country:US
Mailing Address - Phone:585-671-1110
Mailing Address - Fax:585-787-9371
Practice Address - Street 1:630 BAY RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-1241
Practice Address - Country:US
Practice Address - Phone:585-671-1110
Practice Address - Fax:585-787-9371
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185365207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMD185WOtherPREFERRED CARE PROVIDER #
CFP 185365-4OtherWORKERS' COMP.
NYP010185365OtherBLUE CHOICE PROVIDER #
NY1989OtherBC/BS #
NY5297481OtherAETNA PROVIDER #
NY5297481OtherAETNA PROVIDER #
NYC31282Medicare UPIN