Provider Demographics
NPI:1366413031
Name:ROBERT B LANTER DO PC
Entity type:Organization
Organization Name:ROBERT B LANTER DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:LANTER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-766-5495
Mailing Address - Street 1:70 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4225
Mailing Address - Country:US
Mailing Address - Phone:516-766-5495
Mailing Address - Fax:
Practice Address - Street 1:70 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4225
Practice Address - Country:US
Practice Address - Phone:516-766-5495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1815561208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01609970Medicaid
F76093Medicare UPIN
NYW7P661Medicare PIN
NY03154Medicare PIN