Provider Demographics
NPI:1669622023
Name:AMSTERDAM, ROBERT (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:AMSTERDAM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 NORTH STATE ROAD
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510
Mailing Address - Country:US
Mailing Address - Phone:914-762-3131
Mailing Address - Fax:914-762-7485
Practice Address - Street 1:190 N STATE RD
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1471
Practice Address - Country:US
Practice Address - Phone:914-762-3131
Practice Address - Fax:914-762-7485
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027989122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist