Provider Demographics
NPI:1326846486
Name:BUMBY, ROBERT (LSM)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:BUMBY
Suffix:
Gender:
Credentials:LSM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-2543
Mailing Address - Country:US
Mailing Address - Phone:845-652-3170
Mailing Address - Fax:
Practice Address - Street 1:125 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-2543
Practice Address - Country:US
Practice Address - Phone:845-652-3170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01288901225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist