Robert Michael Addon, ATC

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Suffern, NY

NPI 1013249366 · NPPES record last updated Feb 10, 2010

Key facts

NPI
1013249366
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
License
001178 (NY)
Practice address
49 Viola Rd
Suffern, NY 10901-3228
Phone
(845) 590-3829
Fax
(845) 357-4947
NPI assigned
Feb 10, 2010
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
001178NYMDPsychoanalyst

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 001178 NY Yes

Addresses

Primary practice location

49 Viola Rd
Suffern, NY 10901-3228

Mailing address

252 Richard CT
Pomona, NY 10970-2305
Phone (201) 906-1545

Other providers in Suffern, NY

All providers in Suffern, NY · Student in an Organized Health Care Education/Training Program in New York

Sources for this page

Verify at the official NPI Registry.