| Organization Name: | ROBERT J. GOTTLIEB, DPM, PC |
| NPI Number: | 1104072404 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAN M BUDNICK (OFFICE MANAGER) |
| Mailing Address: | 188 W Main St Oyster Bay |
| State: | NY US |
| Postal Code: | 117712267 |
| Phone Number: | 5169220502 |
| Fax Number: | 5169220289 |
| NPI Enumeration Date: | 08/18/2008 |
| NPI Last Update Date: | 08/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | N002806 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |