Provider Demographics
NPI:1679561518
Name:DEAN, ROBERT M (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:DEAN
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 1:2900 HEMPSTEAD TPKE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1404
Mailing Address - Country:US
Mailing Address - Phone:516-227-3333
Mailing Address - Fax:516-227-3345
Practice Address - Street 1:2900 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 203
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1404
Practice Address - Country:US
Practice Address - Phone:516-227-3333
Practice Address - Fax:516-227-3345
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY181309207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01760461Medicaid
NY50K761OtherMEDICARE ID
NY01760461Medicaid