Provider Demographics
NPI:1215912340
Name:STEARNS, ROBERT A (OD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:STEARNS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-2619
Mailing Address - Country:US
Mailing Address - Phone:516-249-0052
Mailing Address - Fax:516-249-7000
Practice Address - Street 1:255 MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-2619
Practice Address - Country:US
Practice Address - Phone:516-249-0052
Practice Address - Fax:516-249-7000
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0024591152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00331315Medicaid
NY00331315Medicaid
NYC98491Medicare PIN
T81385Medicare UPIN
NYA400030767Medicare PIN