Robert J Gottlieb, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

1442901 Issued in NY

Practice address

5 Squiretown Rd
Hampton Bays, NY 11946

Phone

(631) 728-5300

Fax

(631) 728-5360

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1154489847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 RESEARCH WAY",
            "address_2": "STONY BROOK CHILDREN'S SERVICES, UFPC",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "11733",
            "telephone_number": "631-675-2125",
            "fax_number": "631-675-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SQUIRETOWN RD",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "11946",
            "telephone_number": "631-728-5300",
            "fax_number": "631-728-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "1442901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01193815",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aimee Geehreng, MSW
• Brenda Gelzer-Hill, MS, CCC-SLP
• Genovese Drug Stores Inc
• David J Giannone, DMD
• William A Gilmartin, MD
• Marie Gouldsbury
• Esther Gralnick, LCSW
• Harvey Gralnick, D.D.S.
• Brittany Grube, LMHC
• Heath Gutterman, D.P.M.

• Pediatrics Physician in Hampton Bays, NY
• Providers in Hampton Bays, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.