Provider Demographics
NPI:1215171087
Name:BOBIS, FERNANDO (MD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:
Last Name:BOBIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3141 ROUTE 9W
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-6709
Mailing Address - Country:US
Mailing Address - Phone:845-565-9800
Mailing Address - Fax:845-565-4801
Practice Address - Street 1:3141 ROUTE 9W
Practice Address - Street 2:SUITE 100
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-6709
Practice Address - Country:US
Practice Address - Phone:845-565-9800
Practice Address - Fax:845-565-4801
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY266315208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program