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Individual
ROBERT GORMAN
Active
Individual
ROBERT GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11391
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
QQ22K01
EMPIRE BC BS
NY
Enumeration date
12/29/2005
Last updated
08/17/2012
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