Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | X006335-1 | NY |
NPI | 1720204019 |
---|---|
Provider Name | Dr. Robert L Brostowin |
First Address | Wantagh, NY 11793-2000 |
Second Address | Wantagh, NY 11793-2000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 25/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020614752 | GHI (01) | NY |
3031202 | AETNA (01) | NY |
4165432 | CIGNA (01) | NY |
5G21 | EMPIRE BC BS (01) | NY |
C006335-6 | WORKER COMP. (01) | NY |
P2679219 | OXFORD (01) | NY |