Provider Demographics
NPI:1114997509
Name:MAURER, ROBIN S (NP)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:S
Last Name:MAURER
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1001 W FAYETTE ST
Mailing Address - Street 2:STE 400
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-2859
Mailing Address - Country:US
Mailing Address - Phone:315-472-1488
Mailing Address - Fax:315-472-8060
Practice Address - Street 1:792 N MAIN ST
Practice Address - Street 2:STE 200A
Practice Address - City:N SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-1644
Practice Address - Country:US
Practice Address - Phone:315-458-8700
Practice Address - Fax:315-452-0411
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NYF330216363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS65390Medicare UPIN