Individual
MR. ROBERT F MALCOMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
998 CROOKED HILL RD, W BRENTWOOD, NY 11717-1043
(631) 306-5778
Mailing address
19 SANDPIPER CT, SMITHTOWN, NY 11787-3325
(631) 366-4261
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
473687-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
473687-1
—
NY
Enumeration date
01/11/2007
Last updated
07/09/2007
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