Provider Demographics
NPI:1982780243
Name:KAHN, ROBERT J (FNP)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:KAHN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 421
Mailing Address - Street 2:
Mailing Address - City:HARRIS
Mailing Address - State:NY
Mailing Address - Zip Code:12742-0421
Mailing Address - Country:US
Mailing Address - Phone:845-794-9864
Mailing Address - Fax:845-794-9868
Practice Address - Street 1:8081 ROUTE 97
Practice Address - Street 2:CATSKILL REGIONAL MEDICAL CENTER
Practice Address - City:CALLICOON
Practice Address - State:NY
Practice Address - Zip Code:12723
Practice Address - Country:US
Practice Address - Phone:845-887-5530
Practice Address - Fax:845-794-9868
Is Sole Proprietor?:No
Enumeration Date:2006-10-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330973207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY97V561Medicare ID - Type Unspecified
NYS67495Medicare UPIN