Provider Demographics
NPI:1174510135
Name:BYRNE, ROBERT E (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:BYRNE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1221 MAIN ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-5396
Mailing Address - Country:US
Mailing Address - Phone:413-538-9694
Mailing Address - Fax:413-535-3072
Practice Address - Street 1:1221 MAIN ST
Practice Address - Street 2:SUITE 208
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-5396
Practice Address - Country:US
Practice Address - Phone:413-538-9694
Practice Address - Fax:413-535-3072
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2009-04-16
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Provider Licenses
StateLicense IDTaxonomies
MA44143207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0163287Medicaid
N51766Medicare PIN
MA0163287Medicaid