Provider Demographics
NPI:1841339991
Name:BAYEWITCH, ROBERT ERIC (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ERIC
Last Name:BAYEWITCH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 LEGION ST
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-4924
Mailing Address - Country:US
Mailing Address - Phone:516-679-0879
Mailing Address - Fax:
Practice Address - Street 1:2202 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-2000
Practice Address - Country:US
Practice Address - Phone:718-365-6389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0342431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice