Provider Demographics
NPI:1154415289
Name:COWLES, ROBERT ANTHONY (MD)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ANTHONY
Last Name:COWLES
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 208062
Mailing Address - Street 2:333 CEDAR STREET FMB 131
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520
Mailing Address - Country:US
Mailing Address - Phone:203-785-2701
Mailing Address - Fax:203-785-3820
Practice Address - Street 1:3959 BROADWAY
Practice Address - Street 2:RM 216N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1559
Practice Address - Country:US
Practice Address - Phone:212-342-8585
Practice Address - Fax:212-305-9771
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2014-01-29
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Provider Licenses
StateLicense IDTaxonomies
NY2247432086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02583264Medicaid