ROBERT GLENN FORTIN (NPI# 1932178217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932178217 |
| Entity Type | Individual |
| Full Name | ROBERT GLENN FORTIN |
| Credential | M.D. |
| Practice Address |
503 Cranbury Rd East Brunswick NJ 08816-3612 |
| Practice Telephone | 7323908400 |
| Practice Fax Number | 7323908970 |
| Mailing Telephone | 7323908400 |
| Mailing Fax Number | 7323908970 |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2017-03-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
MA055583 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | UNITED ID | 1545372 | 01 |
| NJ | TAX ID | 222694202 | 01 |
| NJ | HIP/PHCS ID | MA055583 | 01 |
| NJ | QUALCARE/GHI NY ID | 8222069 | 01 |
| NJ | HEALTHNET ID | F06244 | 01 |
| NJ | OXFORD ID | P2676733 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043536485 | Robert Fortin | Pharmacist | 9 Clifton Country Rd, Clifton Park, NY 12065-3833 | 2010-04-09 |
| 1972660793 | Robert Felix Fortin | Internal Medicine | 9690 Ventana Way, Alpharetta, GA 30022-6394 | 2007-01-02 |
| Street Address |
503 CRANBURY RD |
| City | EAST BRUNSWICK |
| State | NJ |
| Zip Code | 08816-3612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336118025 | Larry J Tiefenbrunn | Pediatrics | 503 Cranbury Rd, East Brunswick, NJ 08816-3612 | 2006-03-15 |
| 1760802193 | Kristen Runyon | Nurse Practitioner | 503 Cranbury Rd, East Brunswick, NJ 08816-3612 | 2014-04-24 |
| 1760656532 | Tiefenbrunn & Fortin Pediatrics | Pediatrics | 503 Cranbury Rd, East Brunswick, NJ 08816-3612 | 2008-04-14 |
| 1871562173 | Michele P. Tuck | Pediatrics | 503 Cranbury Rd, East Brunswick, NJ 08816-3612 | 2006-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891307955 | Julia Brillante | Psychologist | Center for Cognitive Behavior Therapy, 190 Route 18 North, Suite 203, East Brunswick, NJ 08816 | 2020-08-20 |
| 1790393247 | Caring Homecare LLC | Home Health | 723 Nj - 18, East Brunswick, NJ 08816 | 2020-07-21 |
| 1710527957 | Sophisticated Ventures LLC | Home Health | 197 Nj-18 South Suite 3000, East Brunswick, NJ 08816 | 2020-01-15 |
| 1083251375 | Joshua Persaud Md LLC | Anesthesiology | 2 Pine Meadow Ct, E Brunswick, NJ 08816 | 2019-12-05 |
| 1437718855 | Optimum Heart & Medical Care LLC | Internal Medicine | 172 Summerhill Rd Ste 4, East Brunswick, NJ 08816 | 2019-06-10 |
| 1356805402 | Sr Plastic Surgery PC | Surgery | 2 Cornwall Dr, Unit B2, East Brunswick, NJ 08816 | 2019-01-23 |
| 1083199012 | Kami Ives | Speech-Language Pathologist | 431 Cranbury Rd., East Brunswick, NJ 08816 | 2018-09-25 |
| 1316442460 | Emily Katherine Smith | Physician Assistant | 418 Route 18, East Brunswick, NJ 08816 | 2018-03-29 |
| 1942713649 | Apluscare, LLC | Community/Behavioral Health | 3105 Commons Dr, East Brunswick, NJ 08816 | 2017-11-16 |
| 1093234338 | Larissa Rachel Elk | Occupational Therapist | 11 Mayfair Court, East Brunswick, NJ 08816 | 2017-09-19 |
| Find all providers in zip 08816 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568557064 | Amy Ellen Jaroslow | Pediatrics | 33 Brunswick Woods Drive, East Brunswick, NJ 08816 | 2006-10-03 |
| 1336118025 | Larry J Tiefenbrunn | Pediatrics | 503 Cranbury Rd, East Brunswick, NJ 08816-3612 | 2006-03-15 |
| 1407855406 | Neil Kenneth Cederbaum | Pediatrics | 33 Brunswick Woods Dr, East Brunswick, NJ 08816-5601 | 2005-07-20 |
| 1235373010 | Boram Sung | Pediatrics | 33 Brunswick Woods Dr, East Brunswick, NJ 08816-5601 | 2009-04-24 |
| 1154411478 | Maria Wilma D'mello | Pediatrics | 385 State Route 18, West Ferris Plaza Unit K, East Brunswick, NJ 08816-5703 | 2006-10-15 |
| 1528158409 | East Brunswick Pediatrics Associated | Pediatrics | 33 Brunswick Woods Dr, East Brunswick, NJ 08816-5601 | 2006-10-13 |
| 1730279563 | Larnie Jamal Booker | Pediatrics | 33 Brunswick Woods Dr, East Brunswick, NJ 08816-5601 | 2006-10-13 |
| 1649360405 | Elisabeth M Simon | Pediatrics | 33 Brunswick Woods Drive, East Brunswick, NJ 08816 | 2006-10-13 |
| 1285729566 | Warren Sweberg | Pediatrics | 33 Brunswick Woods Drive, East Brunswick, NJ 08816 | 2006-10-04 |
| 1568557841 | Harold A. Sand | Pediatrics | 33 Brunswick Woods Drive, East Brunswick, NJ 08816 | 2006-10-04 |
| Find all providers in EAST BRUNSWICK | ||||
| City | EAST BRUNSWICK |
| Zip Code | 08816 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.