Robert James Ensmenger

Individual provider Active NPI Athletic Trainer · Old Bethpage, NY

NPI 1801337290 · NPPES record last updated Mar 17, 2017

Key facts

NPI
1801337290
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
7 Beatrice LN
Old Bethpage, NY 11804-1001
Phone
(516) 659-0982
NPI assigned
Mar 17, 2017
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

7 Beatrice LN
Old Bethpage, NY 11804-1001

Mailing address

7 Beatrice Lane
Old Bethpage, NY 11804
Phone (516) 650-0982

Other providers in Old Bethpage, NY

All providers in Old Bethpage, NY · Athletic Trainer in New York

Sources for this page

Verify at the official NPI Registry.