Provider Demographics
NPI:1346245693
Name:HENDLER, ROBERT CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CHARLES
Last Name:HENDLER
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 1:78 CYPRESS RD
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-6814
Mailing Address - Country:US
Mailing Address - Phone:845-294-8841
Mailing Address - Fax:845-294-8106
Practice Address - Street 1:78 CYPRESS RD
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-6814
Practice Address - Country:US
Practice Address - Phone:845-294-8841
Practice Address - Fax:845-294-8106
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120620207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY316711Medicare ID - Type Unspecified
NYB12816Medicare UPIN