Individual
ROBERT T DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
321 W ONONDAGA ST, SYRACUSE, NY 13202-3265
(315) 478-0610
(315) 478-2510
Mailing address
329 N SALINA ST, SYRACUSE, NY 13203-1755
(315) 471-1564
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336163963
—
NY
Enumeration date
09/11/2013
Last updated
01/12/2026
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